Temporomandibular Joint Diseases

Temporomandibular joint (TMJ) disorders imply impaired functions of the joint secondary to intra-or extra-articular pathologies. Temporomandibular joint disorders affect the system that comprise of teeth, cheek, lip, salivary glands, head and neck muscles and ligaments. TMJ disorders are common in young and middle-aged population, especially in women, and they are manifested by symptoms like crackling in temporomandibular joint, headache, ear ache, jaw pain, chewing problem and difficulty opening the mouth.

Temporomandibular joint problems are a group of diseases that require cooperation of physicians from different disciplines. Surgical treatment for temporomandibular joint disorders is performed by Oral and Maxillofacial Surgeons.

WHAT IS TEMPOROMANDIBULAR JOINT?

Temporomandibular joint (TMJ) is the most mobile joint immediately anterior to the external auditory canal, which is the junction of the lower and the upper jaws, between the mandibular fossa and the mandibular condyle beneath the temporal bone.

SYMPTOMS OF TEMPOROMANDIBULAR JOINT IRREGULARITIES AND DISORDERS

All conditions that involve masticator muscles and the structure of the temporomandibular joint are considered as temporomandibular joint irregularity. Pain in the joint, limited mouth opening, joint snapping, and deviation in opening the mouth are the most common clinical symptoms of the temporomandibular joint disorders.

DIAGNOSIS OF TEMPOROMANDIBULAR JOINT DISORDERS

Clinical and radiographic methods are used to diagnose the disorders of the temporomandibular joint. First, the complaints and the history are reviewed in detail. Both dental problems and muscles are examined on the clinical assessment. Clinical findings inform whether the condition is originating from muscle(s) or an intra-articular disorder. Radiographic studies should be started with X-ray of the jaw bone. For further exam, MRI is primarily ordered, when needed. In some rare cases, computerized tomography is scanned.
SIGNIFICANCE OF TREATMENT IN DISORDERS OF TEMPOROMANDIBULAR JOINT

 

Disorders of temporomandibular joint may progress if left untreated. Patients with minimal pain and crackling in front of the ear in the early stage of the condition may experience sudden-onset limited mouth opening and severe pain when they eat hard foods or wake up in the morning. In this condition, called as closed lock, it is required to see a maxillofacial surgeon immediately. In this period, patient should eat soft and liquid foods and take painkiller.

ETIOLOGICAL FACTORS OF TEMPOROMANDIBULAR JOINT DISORDERS

Etiology of temporomandibular joint disorders is not clearly understood. This condition is typically observed in very lean and vulnerable women, while it is rare in men. The disease is caused by grinding and/or clenching teeth, missing teeth, chewing foods by one side of the jaw, parafunctions, bad prosthesis, trauma and orthodontic disorders of the jaw bone. There are also patients with no temporomandibular joint disease, despite presence of such disorders. This shows us that some structural disorders contribute to the development of the temporomandibular joint diseases.

HOW ARE TEMPOROMANDIBULAR JOINT DISEASES TREATED?

Treatment of the temporomandibular joint diseases is carried out in the line with the diagnosis made by the maxillofacial surgeon based on clinical and radiographic exams. After the diagnosis is made, possible treatment options are immobilization, diet, exercise, medicines and surgical procedure. The primary target should be to identify and eliminate the underlying cause. Sometimes, a single treatment modality may not be sufficient. In this case, the option should be multidisciplinary approach. Conservative medical or surgical treatment is instituted depending on the diagnosis of the temporomandibular joint diseases.

WHAT IS THE CONSERVATIVE TREATMENT OF TEMPOROMANDIBULAR JOINT DISEASES?

Medical Treatment, Medications

Various medications, i.e. analgesic, muscle relaxants and antidepressants, are used depending on the type of the joint disorder.
Physiotherapy

This treatment modality includes physiotherapy procedures, such as hot compress, ultrasound, electrotherapy and acupuncture.

Intra-oral appliances

There are many types of appliances that can be applied to the lower jaw or the upper jaw or the both. Specially designed appliances are made of plastic or acrylic material. Although some types are fixed to the teeth, others are designed in the form of removable appliance. Moreover, there are also extra-oral appliances in addition to fixed appliances.

The maxillofacial surgeon may, sometimes, recommend use of occlusal splint in treatment of the temporomandibular joint diseases. The splints made of clear plastic prevent wearing of the teeth and reduces the muscular contractions and the load born on the joints.

Psychological Treatment

Psychological factors play role in some disorders of the temporomandibular joint. There is a connection between the stress and the physical symptoms. Stress may cause physical problems. A psychiatric interview can be useful especially for patients with muscular problems.

WHAT IS THE SURGICAL TREATMENT OF TEMPOROMANDIBULAR JOINT DISEASES?

Surgical treatment is preferred for patients with no response to conservative treatment. Principal surgical treatments instituted in diseases of TMJ;

Arthrocentesis, Irrigation of Joints

Sometimes, conservative treatment and medications alone may fail. In this case, maxillofacial surgeon may decide arthrocentesis. For arthrocentesis, fluid is injected into the joint cavity in front of the ear under local anesthesia, and next, a lubricating substance is instilled. Sometimes, it may be repeated several times.
Temporomandibular Joint (TMJ) Arthroscopy

Arthroscopy is, in fact, a diagnostic procedure that aims detailed examination and treatment of the joint cavity. The patient is administered general anesthesia. The risk is low and it is a minimally invasive surgery. Two small incisions are made to expose the diseased site and the surgical intervention is made.

Open Surgeries

Arthrocentesis is reserved for patients, whom conservative treatment and medications fails. Open surgery is performed for patient who do not respond to these non-invasive treatments. Open surgery is required in approximately 5% of the patient with TMJ diseases. Open surgeries of jaw are carried out under general anesthesia and they are performed to correct problems, such as repair of the disc abnormality, reduction of bone, menisectomy and dislocation of the joint.

PRICES OF TEMPOROMANDIBULAR JOINT SURGERIES

For detailed information on cost of treatment of temporomandibular joint diseases;

  • Please call our Clinic in Bağdat Avenue at 0216 363 36 36
  • Please call our Levent Clinic at 0212 280 88 00
  • Please call our Acarkent Clinic at 0216 485 90 30

For further information, please inform us your e-mail using E-Newsletter section below.

Similar Treatments

Wisdom Teeth and Impcted Teeth

Wisdom Teeth and Impcted Teeth

Wisdom Teeth and Impacted Teeth   Third molar teeth, also known as wisdom teeth, are the final

Jaw Cysts

Jaw Cysts

WHAT ARE JAW CYSTS? “Cyst” is defined as spaces that are located in the soft tissue or the bone, li

Jaw Fractures

Jaw Fractures

HOW DOES JAW FRACTURE OCCUR AND HOW SHOULD JAW FRACTURE BE TREATED? Jaw fractures occur as a result

Maxillary Sinus Lifting

Maxillary Sinus Lifting

WHAT IS MAXILLARY SINUS? The maxillary sinus is formed by anatomic spaces filled by air that are sy

Orthognathic Surgery

Orthognathic Surgery

WHAT IS ORTHOGNATIC SURGERY? Orthognathic surgery can be defined as the combination of orthodontic

Social Media

Subscribe to our campaign

Copyrights © 2017 Dentram Dental Clinics
This site Cosmetic Dentistry and General Dentistry is intended to inform patients about the applications. The information contained in the site content is to inform, certainly no substitute for putting this information to medical purposes examination and diagnosis of the patient's physician.