Mandible/Nasal Bones/TMJ

Are the nasal bones the same for everyone?

no, they vary in shape and size

What do the nasal bones form?

bridge of nose

The nasal bones articulate with the ___________ _______ of the ethmoid bone, posteriorsuperior.

perpendicular plate

Nasal bones articulate with the ________ _____ above.

frontal bone

Nasal bones articulate with ___________ at the sides.

maxillae

What is the largest densest bone of the face?

mandible

What is the curved horizontal portion of the mandible?

body

What are the two verticle portions of the mandible?

rami

Where do the rami unite with the body?

angle of the mandible (gonion)

What is the superior border of the body of the mandible?

alveolar portion

What does the alveolar portion do?

supports the roots of the teeth

What is below the second premolar tooth between the superior and inferior borders of the mandible?

mental foramina

The rami project superiorly at an obtuse angle to the body of the mandible at?

110-120 degrees

What are the two processes on top of the ramus?

coronoid and condylar process

What seperates the two processes on the ramus?

mandibular notch

The TMJ, slants posterior ____ degrees and inferior and medially ___ degrees.

15, 15

The TMJ sits directly in front of what?

EAM

PA Mandibular Rami

- Forehead and Nose on the IR
- OML to be perpendicular
- CR is perpendicular & exits the acanthia

What is shown on the PA Mandibular Rami? (And PA Axial)

- The mandibular body and rami, the central part of the body is not well shown because of the spine.
- Shows medial or lateral displacement of fragments in fractures of the Rami.

PA Axial Rami

- Forehead and Nose on IR
- OML is perpendicular to the IR
- CR 20-25 degrees cephalad to exit the acanthion.

PA Mandibular Body

- Nose & Chin touch the IR to put the AML perpendicular to the IR.
- CR: perpendicular to the lips.
- Shows: Mandibular body

PA Axial Mandibular Body

- Nose and Chin on IR to put the AML perpendicular.
- CR: 30 degrees cephalad between the TMJ's
- Shows mandibular body and TMJ's

What does zanelli recommend on the PA Axial mandibular body?

For more contrast, the patient should fill their mouth with air.

Axiolateral & Axiolateral Oblique Mandible

- Head in lateral with IPL perpendicular, with mouth closed and teeth together.
- Extend the neck so the spine doesn't superimpose.
- CR: 25 degrees cephalad to pass through the region of intrest.

What is the goal of the Axiolateral & Axiolateral Oblique Mandible?

place the mandible parallel with the IR

What to do for the Axiolateral ramus?

head is in true lateral

What to do for the Axiolateral Oblique body?

Rotate patients head 30 degrees toward the IR.

What to do for the Axiolateral Oblique symphysis?

Rotate patients head 45 degrees toward the IR.

SMV of the Mandible

- rest the head on its vertex and put the IOML parallel with the IR
- CR: perpendicular to the IR and enters between the angles of the mandible
- shows the coronoid and condyloid processes of the rami

AP Axial of TMJ

- OML is perpendicular to the IR
- CR: 35 degrees caudad entering 3 inches above the nasion
- Take two pictures one with the mouth open and closed
- Shows condyles of the mandible and mandibular fossae of the temporal bone.

Axiolateral TMJ (Schuller Method)

- True Lateral
- CR: 25-30 degrees caudal entering 1/2in anterior and 2in superior to upside EAM.
- shows TMJ with mouth open and closed

Axiolateral Oblique TMJ (Modified Law Method)

- start in true lateral, the move the MSP of the head 15 degrees toward the IR.
- IPL is perpendicular and the AML is parallel with the transverse axis of the IR.
- take one with the mouth open and closed
- CR: 15 degrees caudal and entering 1 1/2in superior to upside EAM.

What does the modified Law open mouth show?

Mandibular fossa and inferior and anterior excursion of the condyle.

What does the modified Law closed mouth show?

Fractures of the neck and condyle of the ramus.

What does panoramic tomography provide? (panorex)

Panoramic image of the entire mandible and TMJ.