temporomandibular joint syndrome

Temporomandibular joint syndrome is a symptom complex that manifests itself as pain on palpation of the chewing muscles, crackling during movements in the temporomandibular joint (TMJ) and / or pain above it with limited mobility of the lower jaw. The predominant age is 30-50 years. The predominant gender is female (3:1).

Etiology

- Synovitis TMJ
- TMJ disc pathology
- Bruxism – teeth grinding during sleep
- Spasm of chewing muscles
- TMJ injury
- Inadequate fitting of dentures. Risk factors
- The habit of clenching the jaw, grinding the teeth, yawning frequently
- Osteoarthritis, rheumatoid arthritis
- malocclusion
- Fibromyalgia
- Psychosocial stress. Pathomorphology
- Displacement of the mandibular condyle head or anterior TMJ disc
- TMJ capsulitis
- Disc metaplasia leading to disc perforation and degeneration.

Clinical picture

- Pain in the cheekbones and/or TMJ
- Limitation of joint mobility
- Clicking, grinding, crackling during movements in the TMJ
- Headache
- Pain in the ear canal
- Irradiation of pain in the neck.

X-ray examination

- Contrast video arthrography allows you to determine the degree of mobility of the TMJ and disc during chewing. MRI to assess disc position
- Arthroscopy for the purpose of visual examination of intra-articular structures. Differential Diagnosis
- Fracture or dislocation of the lower jaw
- trigeminal neuralgia
- Periodontitis
- Neoplasms with lesions of the TMJ.

Treatment:

Conservative therapy

- Rejection of bad habits that cause muscle tension and excessive mobility of the TMJ
- Fixation of the lower jaw
- Bite correction with orthodontic devices
- Local physiotherapy procedures with thermal effect
- Central muscle relaxants: mydocalm 0.05-0.1 g 2-3 r / day
- NSAIDs: indomethacin 25 mg 3 r / day, voltaren 25 mg 3 r / day, etc. Periodic general blood tests, urine tests, FEGDS are recommended during treatment
- To reduce pain.-.amit-riptyline 25 mg at night.

Surgical treatment should be used to correct a misaligned disc or replace a diseased disc if conservative therapy fails.

Complications

- Chronic dislocation of the TMJ
- Joint contractures
- Depression.