Temporomandibular joint (TMJ) disorders
TMJ problems can manifest in very different ways, such as by pain directly over the joint, with discomfort centered in the chewing muscles, or by TMJ clicks.
Symptoms
Most frequent symptoms in TMJ problems are:
- Pain in the joint or the mastication muscles
- TMJ noises (clicking / rubbing)
- Limited ability to open the mouth
- Luxation
- Unclear bite of the teeth
The cause of TMJ problems can also be very different.
Diseases
Common diseases are:
- Luxation of the disc
- Luxation of the joint
- Hypertrophy of the masticatory muscles
- Arthrosis
- Arthritis
- Abnormalities in the area of the temporomandibular joint
Often due to overloading, such as by crunching under stress, TMJ can cause pain in the adjacent mastication muscles. This pain is often expressed in symptoms that radiate to the border of the mandible or the temple. Lumps are also often found in these muscle groups. The arthrogenic cause is often a so-called anterior disc luxation before, that the flexible disk in the temporomandibular joint is displaced forward. The initial patient complaint is often related to a clicking sound of the joint upon opening and closing the mouth. This clicking can then disappear when there is a permanent malposition of the joint disk. An isolated TMJ click is harmless. However, if there is any additional pain or restricted movement, then further clarification and possibly therapy should take place.
Therapy
For complaints of the temporomandibular joint, hard foods and chewing gum should be avoided. Basically, a treatment that is as conservative as possible is preferred; that is, without any major operations, if possible. For more radiating pain and painful pressure points / hardening throughout the chewing muscles, stress reduction and physical therapy are at the forefront of treatment. It is important to regularly perform certain exercises at home, possibly in combination with a rail that should be worn overnight for a few months.
TMJ lavage (arthrocentesis / lavage)
While TMJ flushing is being performed, the upper joint space is dotted with 2 needles and rinsed with pressurized liquid to remove debris and inflammatory mediators.
TMJ Reflection (arthroscopy)
During TMJ arthroscopy, a small camera is inserted into the upper joint space in anesthesia in addition to a needle. The joint space is flushed with fine instruments so that minor adhesions are dissolved.
Open TMJ surgery
If the previously mentioned methods do not result in significant improvement or if increasing symptoms (e.g. in severe arthritic changes) appear, then the joint can be reached via an access an incision in front of the ear in full anesthesia. For replacement of the disc – if necessary- we use patients` own tissue to replace the disc.