‫بسم هللا الرحمن الرحيم‬

‫‪Dr. Amal Rekaby‬‬

 Trismus
(Limited mandibular movement)

Dr. Amal Rekaby

 ILOS
 Mention the etiology of trismus
 Describe treatment modalities for
trismus

Dr. Amal Rekaby

Etiology Of Trismus

Dr. Amal Rekaby

 1) Acute Factors
1. Local trauma; as inferior alve.N block

2. Infection ptergo-mand& later. Pharyng.

spaces, pericoronitis following oral
surgery

3. Psychological

Dr. Amal Rekaby

Dr. Amal Rekaby
2) Chronic Factors
1. TMJ dysfunction

2. Poor joint architecture (malposition of the

disk)

3. Rheumatoid arthritis

4. Pathological process the condyle as ;

osteoma.zygoma., cysts. coronoid or
condyle over growth

5. ankylosis

Dr. Amal Rekaby

 TMJ DISORDER

 Temporomandibular joint and muscle

disorders, commonly called “TMJ,”
are a group of conditions that cause
pain and dysfunction in the jaw joint
and the muscles that control jaw
movement.

Dr. Amal Rekaby

 TMJ DISORDER
 1 Myofascial pain involves discomfort or pain in
the muscles that control jaw function.
 2 Internal derangement of the joint involves a
displaced disc, dislocated jaw, or injury to the
condyle.
 3 Arthritis refers to a group of degenerative/
inflammatory joint disorders that can affect the
temporomandibular joint.

Dr. Amal Rekaby

3) Treatment Related Factors
1. Radiation therapy
2. Surgical treatment
3. orthognathic surg.

Dr. Amal Rekaby

 1-Protruding muscles:
Masseter,Med pterygoid, Lateral pterygoid
2-Retruding muscles:
Post fs of Temporalis,Suprahyoid ms
3-Elevators (closing)Muscles:
Masseter,Medial pterygoid,ant &middle fs of
temporalis
4-Depressors (opening)Muscles:
Lateral pterygoid,Suprahyoid muscles
5-side to side Muscles:
The alternating action of the pterygoid
muscle one side only contract

Dr. Amal Rekaby

Dr. Amal Rekaby
 Treatment
 Medical ; as antibiotic, anti-inflamatory&
muscle relaxant

 Surgical removal of cysts or tumors

 Physical
• Exercises (opening 20, lateral
excursion 10) no chewing gum

• Mechanical devices (simple & Dynamic

bite opener)

Dr. Amal Rekaby

Simple device

Tapered threaded acrylic screw

Dr. Amal Rekaby
Dr. Amal Rekaby
Tongue depressor
Dr. Amal Rekaby
(Dynamic bite opener)

1. Trismus stent (TMJ exerciser)

2. Inflatable bite opener
3. Intraoral prosthesis with
interarch spring

Dr. Amal Rekaby

Trismus stent, TMJ exerciser
Dr. Amal Rekaby
Trismus stent, TMJ exerciser
Bilateralforce
Better prognosis with teeth

Steel frame-work, maxillary

&mandibular stent

Dr. Amal Rekaby

Dr. Amal Rekaby
Dr. Amal Rekaby
Dr. Amal Rekaby
Dr. Amal Rekaby
Dr. Amal Rekaby
Dr. Amal Rekaby
Intra0ral prosthesis with interarch spring

Dr. Amal Rekaby

THANK YOU
Dr. Amal Rekaby