Skip to main content

Advertisement

SpringerLink
Log in

Temporomandibular joint anatomy, function and clinical relevance

  • Clinical
  • Published:
British Dental Journal Submit manuscript

Abstract

The articulatory system comprises the temporomandibular joints (TMJs), intra-articular discs, mandibular/jaw muscles and occlusion. In the simplest terms, the TMJ is the articulation between the upper and lower jaws. The teeth form the contacts between the upper and lower jaws and the muscles are the motors that move the mandible. This system is unique in that the TMJs are paired; any stimulus that affects one joint or any other single part of the articulatory system can have a 'knock-on effect' in the rest of the system.

It is important to have a good understanding of anatomy, not only to be able to differentiate between what is physiological and what is pathological, but also to understand the objectives of some treatment options. Sound knowledge of anatomy is essential and an appreciation of the anatomical features associated with the TMJ can serve as a foundation for understanding the clinical management of temporomandibular disorders.

This article reviews the functional anatomical features of the articulatory system with a look at the clinical significance of this anatomy.

Key points

  • Provides an understanding of the anatomy of the TMJ and surrounding associated structures.

  • Gives an understanding of the clinical issues arising from the pathology of supporting elements of the TMJ and the joint itself, plus how to assess the TMJ to aid diagnosis of TMJ disorders.

  • Summarises aspects of this area of dentistry which is typically poorly understood by general dental practitioners.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13

Similar content being viewed by others

References

  1. Alomar X, Medrano J, Cabratosa J et al. Anatomy of the temporomandibular joint. Semin Ultrasound CT MR 2007; 28: 170-183.

  2. Al-Ani Z, Grey R. Temporomandibular Disorders: A Problem-Based Approach. 2nd ed. New Jersey: Wiley-Blackwell, 2021.

  3. Choukas N C, Sicher H. The structure of the temporomandibular joint. Oral Surg Oral Med Oral Pathol 1960; 13:1203-1213.

  4. Coulthard P, Horner K, Sloan P, Theaker E D. Master Dentistry: Volume 1: Oral and Maxillofacial Surgery, Radiology, Pathology and Oral Medicine. Amsterdam: Elsevier Health Sciences, 2013.

  5. Yale S H. Radiographic evaluation of the temporomandibular joint. J Am Dent Assoc 1969; 79: 102-107.

  6. Katzberg R W, Dolwick M F, Helms C A, Hopens T, Bales D J, Coggs G C.Arthrotomography of the temporomandibular joint. AJR Am J Roentgenol 1980; 134: 995-1003.

  7. Al-Ani Z. Temporomandibular Joint Osteoarthrosis: A Review of Clinical Aspects and Management. Prim Dent J 2021; 10: 132-140.

  8. Savalle W R M. Some Aspects of the Morphology of the Human Temporomandibular Joint Capsule. Cell Tissue Organ 1988; 131: 292-296.

  9. Berkovitz B K, Holland G R, Moxham B J. Oral Anatomy, Histology and Embryology. Missouri: Mosby, 2009.

  10. Loughner B A, Gremillion H A, Mahan P E, Watson R E. The medial capsule of the human temporomandibular joint. J Oral Maxillofac Surg 1997; 55:363-369.

  11. Voermans N C, Knoop H, Bleijenberg G, van Engelen B G. Pain in ehlers-danlos syndrome is common, severe, and associated with functional impairment. J Pain Symptom Manage 2010; 40: 370-378.

  12. Di Giacomo P, Celli M, Ierardo G, Polimeni A, Di Paolo C. Evaluation of Temporomandibular Disorders and Comorbidities in Patients with EhlerDanlos: Clinical and Digital Findings. J Int Soc Prev Community Dent 2018; 8: 333-338.

  13. Rees L A. The structure and function of the mandibular joint. Br Dent J 1954; 96:125-133.

  14. Cuccia A M, Caradonna C, Caradonna D et al. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications. Imaging Sci Dent 2013; 43:37-44.

  15. Schmidt B L, Pogrel M A, Necoechea M, Kearns G. The distribution of the auriculotemporal nerve around the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998; 86: 165-168.

  16. Davidson J A, Metzinger S E, Tufaro A P, Dellon A L. Clinical implications of the innervation of the temporomandibular joint. J Craniofac Surg 2003; 14: 235-239.

  17. Grant P G. Lateral pterygoid: two muscles? Am J Anat 1973; 138:1-9.

  18. Schmolke C. The relationship between the temporomandibular joint capsule, articular disc and jaw muscles. J Anat 1994; 184: 335-345.

  19. McNamara J A Jr. The independent functions of the two heads of the lateral pterygoid muscle. Am J Anat 1973; 138:197-205.

  20. Wood W W. A review of masticatory muscle function. J Prosthet Dent 1987; 57:222-232.

  21. Davies S J, Grey R M J. The examination and recording of the occlusion: why and how. Br Dent J 2001; 191:291-302.

  22. Koolstra J H, Naeije M, van Eijden T M. The three-dimensional active envelope of jaw border movement and its determinants. J Dent Res 2001; 80:1908-1912.

  23. Posselt U. Studies in The Mobility of the Human Mandible. Acta Odontologica Scandinavica, 1952.

  24. Wilson P H R, Banerjee A.. Verifiable CPD paper: Recording the retruded contact position: a review of clinical techniques. Br Dent J 2004; 196: 395-402.

  25. Türp J C, Minagi S. Palpation of the lateral pterygoid region in TMD - where is the evidence? J Dent 2001; 29: 475-483.

  26. Drake R L, Grey H, Vogl W, Mitchell A W. Grey's Anatomy for Students. Amsterdam: Elsevier Health Sciences, 2005.

  27. Grey H. Anatomy of the human body. Lea & Febiger, 1878.

  28. Abdullakutty, A. Sidebottom A J. Surgical Pathways to the Temporomandibular Joint. In Contemporary Management of Temporomandibular Disorders. pp 37-56. Cham: Springer, 2019.

  29. Kenhub. Muscles of mastication. 2022. Available at https://www.kenhub.com/en/library/anatomy/themusclesof-mastication (accessed November 2021).

Download references

Acknowledgements

The authors wish to acknowledge John Wilkie for his outstanding artwork and Miss Nada Kasbar in permitting us to use her as a photographic model for the clinical photos.

Author information

Authors and Affiliations

  1. University of Glasgow, Glasgow, UK

    Greg Wilkie

  2. Senior Lecturer, Restorative Dentistry, Glasgow Dental Hospital and School, University of Glasgow, Glasgow, UK

    Ziad Al-Ani

Authors
  1. Greg Wilkie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ziad Al-Ani
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Greg Wilkie wrote all of the information on anatomy and function and Ziad Al-Ani wrote all of the clinical relevance sections.

Corresponding author

Correspondence to Greg Wilkie.

Ethics declarations

The authors declare no conflicts of interest.

Consent to publish was obtained for the photographs in Figures 10-13.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilkie, G., Al-Ani, Z. Temporomandibular joint anatomy, function and clinical relevance. Br Dent J 233, 539–546 (2022). https://doi.org/10.1038/s41415-022-5082-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41415-022-5082-0

  • Springer Nature Limited

This article is cited by

Search

Navigation