Week 7 :Mandible Week 8 : TMJ - PowerPoint PPT Presentation

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Week 7 :Mandible Week 8 : TMJ

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Week 7 :Mandible Week 8 : TMJ RT 233 Week 7 & 8 (FINAL) Axiolateral Oblique TMJ Semiprone or seated Center anterior to EAM Rest cheek on grid device Rotate MSP ... – PowerPoint PPT presentation

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Title: Week 7 :Mandible Week 8 : TMJ


1
Week 7 Mandible Week 8 TMJ
  • RT 233 Week 7 8
  • (FINAL)

2
Mandible
3
Mandible (Slide 3)
  1. Only movable bone in the skull
  2. Densest largest facial bone
  3. 2 bones at birth
  4. Contains mental foramina

4
Temporomandibular Joint
5
Indications
  • 1
  • 2
  • 3

6
PA Mandible (rami)
  1. ________ or ________
  2. _________________ and nose on IR
  3. ________ ________ perpendicular to IR
  4. CR perpendicular to exit _____________

7
PA Mandible (rami) Radiograph
  • 1. Mandibular ________
  • 2. ________ portion of ______ are visualized
  • 3. Entire mandible without _________ or _________
  • 4. _________ or __________ displacement

8
PA Mandible Rami- Diagram
9
PA Mandible (body)
  • ________or _______
  • ____ and ____ on grid device or table
  • Mandibular symphysis ______with plane of IR
  • ___ ___ perpendicular to IR
  • CR perpendicular to level of ________

10
PA Mandible (body) Radiograph
  • Contrast and density are sufficient to view body
    and rami
  • Sharp bony detail indicating no motion

11
PA Axial (rami)Mandible Positioning
  • Seated or _______
  • Forehead and _____ on IR
  • _____ MSP perpendicular to IR
  • CR 20- 25 _________, centered to exit
    _______________

12
PA Axial (rami)Mandible Radiographs
  1. Heads of ________ are visible through ______
    processes.
  2. Condyloid processes are slightly _________.
  3. Proper density
  4. No rotation or tilt

13
PA Axial (body)Mandible Positioning
  • Seated or Prone
  • ____ and ____on grid device or table
  • mandibular symphysis ___________ with IR
  • ____ _____ perpendicular to IR
  • CR between TMJs, 30 ____________

14
PA Axial (body)Mandible Radiographs
  • TMJs just ________ to mastoid process
  • Symmetric ______
  • Adequate contrast and density

15
Axiolateral Oblique Positioning for Ramus
  • Seated, semiprone or semisupine
  • IPL ____________ to IR
  • Mouth closed- _________ together
  • Extend neck, chin ___________forward
  • CR __ degrees _____to pass through area of
    interest

16
Axiolateral Oblique Radiograph for Ramus
  1. No overlap of ramus by opposite side of mandible
  2. No elongation or foreshortening of ramus
  3. No superimposition of ramus by c-spine

17
Axiolateral Oblique Positioning for Body
  1. Seated, semiprone or semisupine
  2. IPL perpendicular to IR
  3. Mouth closed- teeth together
  4. Extend neck, chin jutted forward
  5. Rotate pts head _________ degrees toward IR
  6. CR 25 degrees cephalic to pass through area of
    interest

18
Axiolateral Oblique Radiograph for Body
  1. No overlap of body by opposite side of mandible
  2. No elongation or foreshortening of body
  3. No superimposition of body by c-spine

19
Axiolateral Oblique Positioning for Mandibular
Symphysis
  • Seated, semiprone or semisupine
  • IPL perpendicular to IR
  • Mouth closed- teeth together
  • Extend neck, chin jutted forward
  • Rotate pts head __ degrees toward IR
  • CR 25 degrees cephalic to pass through area of
    interest

20
Axiolateral Oblique Radiograph for Mandibular
symphysis
  • No overlap of mentum by the opposite side of
    mandible
  • No foreshortening of the mentum region

21
SMV Mandible
  • IOML parallel to IR
  • Shows coronoid and condylod processes orf rami

22
SMV
23
SMV Radiograph
  • Condyles anterior to pars petrosae
  • Symphysis extended almost past border of face
  • Equal distance from condyles to lateral margin of
    skull

24
Panorex Mandible
  1. Explain how tube/image receptor move
  2. IOML perpendicular
  3. Stand straight, not jutting chin forward
  4. Instruct pt to keep lips together and tongue on
    roof of mouth

25
Panorex Mandible Radiographs
  • Demonstrates teeth, mandible, TMJs
  • Density are uniform across image
  • No artifacts

26
Fractures and Surgical Repair
27
Surgical Fixation
28
Jaw wired shut
29
(No Transcript)
30
(No Transcript)
31
Temporomandibular Articulations
32
AP Axial TMJ
  1. Supine or seated upright
  2. Posterior teeth closed and in contact
  3. For open mouth- wide as possible without chin
    jutted forward
  4. OML perp to IR
  5. CR 35 caudad, centered midway between TMJs.
  6. Enters approx 3 above nasion

33
AP Axial TMJ Radiograph
  • No rotation
  • Minimal superimposition of petrosa on condyle in
    closed mouth
  • Condyle and TMJ below pars petrosa in open mouth

34
Axiolateral Oblique TMJ
  1. Semiprone or seated
  2. Center ½ anterior to EAM
  3. Rest cheek on grid device
  4. Rotate MSP approx 15 degrees toward IR
  5. IPL perpendicular
  6. CR 15 caudad exiting through TMJ closest to IR
    about 1 ½ superior to upside EAM

35
Axiolateral Oblique TMJ Radiograph
  • TMJ
  • Condyle lying in mandibular fossa in closed mouth
  • Condyle lying inferior to articular tubercle in
    open mouth

36
Axiolateral Oblique Open mouth
37
Axiolateral Oblique Open mouth
Temporomandibular fossa
condyle
Coronoid
38
Axiolateral ObliqueClosed mouth
39
Axiolateral ObliqueClosed mouth
Temporomandibular fossa
condyle
coronoid
40
Axiolateral TMJs
  • CR 25-30 degrees
  • Enters ½ anterior and 2 superior to upside EAM
  • IPL Perpendicular
  • MSP parallel

41
Evaluation Criteria
  • TMJ lying anterior to the EAM
  • Condyle in fossa (closed mouth)
  • Condyle inrerfior to articular tubercle (open
    mouthP

42
Axiolateral Closed Mouth
43
Axiolateral Open Mouth
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