mandible & tmj lecture rt 233 week 7. hello class, this is my preliminary lecture, i may add...
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Mandible & TMJ Lecture
RT 233 Week 7
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Hello class, This is my preliminary lecture, I may add more
slides over the weekend. Please check back on Sunday evening for any revisions.
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Mandible
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Mandible
Only movable bone in the skull
Densest & largest facial bone
2 bones at birth
Contains mental foramina
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Temporomandibular Joint
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PA Mandible (rami)
Seated or Prone
Forehead and nose on IR
OML & MSP perpendicular to IR
CR perpendicular to exit acanthion
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PA Mandible (rami) Radiograph
Mandibular rami and lateral portion of body are visualized
Entire mandible without rotation or tilt
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PA Mandible Rami- Diagram
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PA Mandible (body)
Seated or Prone
Nose and chin on grid device or table placing mandibular symphysis parallel with plane of IR
AML & MSP perpendicular to IR
CR perpendicular to level of lips
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PA Mandible (body) Radiograph
Contrast and density are sufficient to view body and rami
Sharp bony detail indicating no motion
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PA Axial (rami)Mandible Positioning Seated or Prone
Forehead and nose on IR
OML & MSP perpendicular to IR
CR 20- 25 cephalic, centered to exit acanthion
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PA Axial (rami)Mandible Radiographs
TMJ and heads of condyles are visible through mastoid processes.
Condyloid processes are well visualized, slightly elongated.
Entire mandible with no rotation or tilt with adequate density
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PA Axial (body)Mandible Positioning Seated or Prone
Nose and chin on grid device or table placing mandibular symphysis parallel with plane of IR
AML & MSP perpendicular to IR
CR between TMJ’s, 30 cephalad.
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PA Axial (body)Mandible Radiographs
TMJ’s just inferior to mastoid process
Symmetric rami
Adequate contrast and density
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AP Axial – Towne Method
OML & MSP perpendicular to IR
CR 35-40 caudad
Centered to glabella midway between EAMS and angles of mandible
If IOML is used increase CR angle 7 degrees
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AP Axial- Towne Method Radiograph
Demonstrates condyloid processes symmetrically
Clear visualization of TMJ fossae and condyle relationship
Minimal SI of TM fossae and mastoid portions
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Axiolateral Oblique Positioning for Ramus Seated, semiprone or
semisupine
IPL perpendicular to IR
Mouth closed- teeth together
Extend neck, chin jutted forward
CR 25 degrees cephalic to pass through area of interest
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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
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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 30 degrees toward IR
CR 25 degrees cephalic to pass through area of interest
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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
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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 45 degrees toward IR
CR 25 degrees cephalic to pass through area of interest
![Page 22: Mandible & TMJ Lecture RT 233 Week 7. Hello class, This is my preliminary lecture, I may add more slides over the weekend. Please check back on Sunday](https://reader030.vdocument.in/reader030/viewer/2022032723/56649d0a5503460f949dcd8d/html5/thumbnails/22.jpg)
Axiolateral Oblique Radiograph for Mandibular symphysis
No overlap of mentum by the opposite side of mandible
No foreshortening of the mentum region
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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
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Panorex Mandible Radiographs
Demonstrates teeth, mandible, TMJ’s
Density are uniform across image
No artifacts
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AP Axial Temporomandibular
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
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AP Axial TMJ Radiograph
No rotation
Minimal superimposition of petrosa on condyle in closed mouth
Condyle and TMJ below pars petrosa in open mouth
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Axiolateral 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
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Axiolateral TMJ Radiograph
TMJ
Condyle lying in mandibular fossa in closed mouth
Condyle lying inferior to articular tubercle in open mouth
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Axiolateral Open mouth
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Axiolateral Closed mouth