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Trismus is defined as painful restriction in opening the mouth due to a muscle spasm, [5] however it can also refer to limited mouth opening of any cause. [6] Another definition of trismus is simply a limitation of movement. [4] Historically and commonly, the term lockjaw was sometimes used as a synonym for both trismus [2] and tetanus. [7]
Over time, the amount of mouth opening possible without pain can be gradually increased. A baseline record of the distance at the start of physical therapy (e.g. the number of fingers that can be placed vertically between the upper and lower incisors), can chart any improvement over time. [49]
The inferior compartment allows for rotation of the condylar head around an instantaneous axis of rotation, [14] corresponding to the first 20mm or so of the opening of the mouth. After the mouth is open to this extent, the mouth can no longer open without the superior compartment of the temporomandibular joints becoming active.
The four classical muscles of mastication elevate the mandible (closing the jaw) and move it forward/backward and laterally, facilitating biting and chewing. Other muscles are responsible for opening the jaw, namely the geniohyoid , mylohyoid , and digastric muscles (the lateral pterygoid may play a role).
Ask the patient to open and close whilst placing two fingers over the space of the TMJ. Opening of less than 35mm in the mandible is considered to be restricted and such restriction may be associated with intra-capsular changes within the joint. [28] Following this, ask the patient to move their jaw to the right and following this, to the left.
Root canal treatment should be performed on the tooth if it is determined that previous therapy was unsuccessful. Removal of the necrotic pulp and the inflamed tissue as well as proper sealing of the canals and an appropriately fitting crown will allow the tooth to heal under uninfected conditions.
Jennings gag. In the context of surgery or dental surgery, a gag is a device used to hold the patient's mouth open when working in the oral cavity, or to force the mouth open when it cannot open naturally because of forward dislocation of the jaw joint's intraarticular cartilage pad.
Condylar resorption, also called idiopathic condylar resorption, ICR, and condylysis, is a temporomandibular joint disorder in which one or both of the mandibular condyles are broken down in a bone resorption process.