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Week 7 :Mandible Week 8 : TMJ

Week 7 :Mandible Week 8 : TMJ. RT 233 Week 7 & 8 (FINAL). Mandible. Mandible (Slide 3). Only movable bone in the skull Densest & largest facial bone 2 bones at birth Contains mental foramina. Temporomandibular Joint. Indications. 1 2 3. PA Mandible (rami). ________ or ________

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Week 7 :Mandible Week 8 : TMJ

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  1. Week 7 :Mandible Week 8 : TMJ RT 233 Week 7 & 8 (FINAL)

  2. Mandible

  3. Mandible (Slide 3) • Only movablebone in the skull • Densest & largest facial bone • 2bones at birth • Contains mental foramina

  4. Temporomandibular Joint

  5. Indications 1 2 3

  6. PA Mandible (rami) • ________ or ________ • _________________ and nose on IR • ________& ________ perpendicular to IR • 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 • Heads of ________ are visible through ______ processes. • Condyloid processes are slightly _________. • Proper density • 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 TMJ’s, 30 ____________

  14. PA Axial (body)Mandible Radiographs • TMJ’s 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 • No overlap of ramus by opposite side of mandible • No elongation or foreshortening of ramus • No superimposition of ramus by c-spine

  17. Axiolateral Oblique Positioning for Body • Seated, semiprone or semisupine • IPL perpendicular to IR • Mouth closed- teeth together • Extend neck, chin jutted forward • Rotate pt’s head _________ degrees toward IR • CR 25 degrees cephalic to pass through area of interest

  18. Axiolateral Oblique Radiograph for Body • No overlap of body by opposite side of mandible • No elongation or foreshortening of body • 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 pt’s 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 • Explain how tube/image receptor move • IOML perpendicular • Stand straight, not jutting chin forward • Instruct pt to keep lips together and tongue on roof of mouth

  25. Panorex Mandible Radiographs • Demonstrates teeth, mandible, TMJ’s • Density are uniform across image • No artifacts

  26. Fractures and Surgical Repair

  27. Surgical Fixation

  28. Jaw wired shut

  29. Temporomandibular Articulations

  30. AP Axial TMJ • Supine or seated upright • Posterior teeth closed and in contact • For open mouth- wide as possible without chin jutted forward • OML perp to IR • CR 35 caudad, centered midway between TMJ’s. • Enters approx 3” above nasion

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

  32. Axiolateral Oblique TMJ • Semiprone or seated • Center ½” anterior to EAM • Rest cheek on grid device • Rotate MSP approx 15 degrees toward IR • IPL perpendicular • CR 15 caudad exiting through TMJ closest to IR about 1 ½ “ superior to upside EAM

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

  34. Axiolateral Oblique Open mouth

  35. Axiolateral Oblique Open mouth Temporomandibular fossa condyle Coronoid

  36. Axiolateral ObliqueClosed mouth

  37. Axiolateral ObliqueClosed mouth Temporomandibular fossa condyle coronoid

  38. Axiolateral TMJ’s • CR 25-30 degrees • Enters ½” anterior and 2” superior to upside EAM • IPL Perpendicular • MSP parallel

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

  40. Axiolateral Closed Mouth

  41. Axiolateral Open Mouth

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