JOINT
ANATOMY,
DEVELOPMENT
&
SURGICAL
ANATOMY
Capsule
Articular disc
Ligaments
Muscular component
THE MANDIBULAR
CONDYLE
An ovoid process seated atop a
narrow mandibular neck. Its the
articulating surface of the
mandible.
It is a biconcave fibrocartilaginous
structure located between the
mandibular condyle and the temporal
bone component of the joint.
1. anterior band = 2 mm in
thickness,
2. posterior band = 3 mm thick,
3. thin in the centre intermediate
band of 1 mm thickness.
More posteriorly there is a
bilaminar or retrodiscal
region.
The outline
anterolaterally to the articular tubercle,
laterally to the lateral rim of the mandibular
fossa,
posterolaterally to the postglenoid process,
posteriorly to the posterior articular ridge,
medially to the medial margin of the
Patnaik VVG, Bala S,Singla Rajan
K: Anatomy of temporomandibular
temporal,
joint? A review. J Anat Soc India anteriorly it is attached to the preglenoid
49(2):191-197, 2000
plane
The outline of attachment on the
mandibular neck -
Contains:
Hyaluronic acid which is highly viscous
May also contain some free cells mostly macrophages.
Functions:
Lubricant for articulating surfaces.
Carry nutrients to the avascular tissue of the joint.
Clear the tissue debris caused by normal wear and tear of
the articulating surfaces.
Muscular Component
The masticatory muscles surrounding the joint are groups
of muscles that contract and relax in harmony so that the
jaws function properly.
When the muscles are relaxed and flexible and are not
under stress, they work in harmony with the other parts of
the TMJ complex.
Hiltons Law:
The principle that the nerve supplying a joint also supplies both the
muscles that move the joint and the skin covering the articular insertion of
those muscles.
Ruffini Endings
Position the mandible
Pacinion Receptors
Accelerate movement during Reflexes
Golgi tendon Organs
Protection of ligaments Around TMJ
Free Nerve Endings
Pain receptors
Pacinian Corpuscle
Onion-like
encapusulated pressure
receptors
Surrounding concentric
lamellae respond to
distortion, generate
action potential in
unmyelinated fiber in
core
Bar = 100 microns
http://www.kumc.edu/instruction/medicine/anatomy/hi
stoweb/nervous/nervous.htm
Ruffinis & Golgi Corpuscle
Function:
Ruffinis = Posture (proprioception), dynamic and static balance
www.anatomyatlases.org/ MicroscopicAnatomy/Section06/Section06.shtml
HISTOLOGY
OF
ARTICULAR SURFACE OF TMJ
1. The articular zone
. Dense fibrous
connective tissue
. Poor blood supply
. Better ability to
repair
Good adaption to sliding movement
Shock absorber
Less susceptible to the effect of aging
time & breakdown over time.
2. The proliferative
zone
Mainly cellular
zone
Undifferentiated
mesenchymal cells
Proliferation &
regeneration
throughout life
3. The cartilagenous
zone
Collagen fibers
arranged in criss
-cross pattern of
bundles
Deepest zone
Chondrocytes,
chondroblasts &
osteoblasts
Active site for remodeling activity as bone
growth proceeds.
RELATIONS
artery
A careful dissection of 16
intact human cadaveric
head specimens revealed
The location of the
masseteric artery was
then determined in
relation to 3 points
process:
1) the anterior-superior
aspect of the condylar
neck = 10.3 mm; Bashar M. Rajab, Ammar A.
2) the most inferior aspect of Sarraf, A. Omar Abubaker
, Daniel M. Laskin Masseteric
the articular tubercle = Artery: Anatomic Location and
11.4 mm; Relationship to the Temporomand
ibular Joint Area Journal of Or
3) the inferior aspect of the al and Maxillofacial Surgery
. 2009;67 (2) : 369371
sigmoid notch = 3 mm.
RELATIONS
Laterally
Disk:
Becomes thinner.
Shows hyalinization and chondroid changes.
Synovial fold:
Become fibrotic with thick basement membrane.
PAPOWICH &
CARNE 1982
AL-KAYAT & BRAMLEY 1979
For a wider exposure.
A question mark shaped skin incision which
avoids main vessels and nerves.
About 2 cm above the malar arch, the temporalis
fascia splits into 2 parts, which can be easily
identified by fat globules between 2 layers which
form an important landmark.
In this, temporal facia and superficial temporal
artery are reflected with skin flap. Later helps in
better healing of the flap.
Under no circumstances should the inferior end
of the skin incision be extended below the lobe
of the ear as it increases the risk of damage to
main trunk of facial nerve. It is particularly
important in children where it may be quite
superficial.
The length of the facial nerve which is visible
to the surgeon is about 1.3 cm.
In 30 patients study of
precise location of the
temporal branch of the
facial nerve in relation to
the most anterior aspect of
the bony external acoustic
canal was done by
Miloro et al