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Temporomandibular Joint
Articulation, muscles or both cause the problem?
Temporomandibular joint is a small joint located in front of the ear at the point where the base of the skull and lower jaw are joined. It allows the lower jaw to move and function.
TMJ dysfunctions are not uncommon and have a variety of symptoms; patients report pain in the ear, headaches and restriction on mouth opening.
Patients also complain for sounds during maximum opening and many times at the beginning of opening (or closing) associated with pain.
What causes dysfunction of the temporomandibular joint?
Arthritis is one of the causes of symptoms of temporomandibular joint. It may arise from trauma to the joint, or by teeth clenching and grinding during night sleep.
Another common cause is the ectopic location or the asynchronous movement of the disc structures located between the hinge. A disk with asynchronous movement causes sounds when the mouth opens, while disc in ectopic position causes sounds and reduce opening range and pain.
The disk may also be thinned or punctured which induces pain and friction sound. There are also situations / conditions such as rheumatoid arthritis or trauma which may cause compound of joint parts and prevent the whole opening.
What is the range of possible treatments?
In the case of TMJ dysfunction, there is an extensive range of available treatments. In it's simplest form, there may be simple prescription or even open surgery in most complex cases.
There are also other solutions such as occlusal equilibratio, construction and usage of occlusal splin, etc.
In particular, if the non-surgical approach is not successful or if there is obviously some damage to the joint components, it is likely to need surgery.
This in turn may be either arthroscopy (just like the major orthopedic surgery in e.g. knee joints) or the open operation performed in front of the ear.
If the diagnosis of temporomandibular dysfunction of structuring set correctly then the appropriate treatment can be provided.
The Role of Oral and Maxillofacial Surgeon in the diagnosis of temporomandibular joint dysfunction.
When there are symptoms of TMJ dysfuction (i.e. pain in the front of the ear, pain during mastication, difficulty / limitation of mouth opening, etc), you should contact an oral and maxillofacial surgeon to get a correct diagnosis.
You may need specialized tests (MRI of the joints) or even the contribution of other specialists or physical therapist for treatment.
