What is the pathology of the temporomandibular joint (TMJ)?
The pathology of the temporomandibular joint, as its name suggests, is the pathology that affects the jaw joint. This articulation is very special and very characteristic in the organism because it must work bilaterally, the right and left temporomandibular joint must move and rotate at the same time and in order so that the mandibular movement is correct. This movement is conveyed by an articular disc or meniscus that leads to a muscle, the pterygoid. This muscle will pull the disc and move it to facilitate the opening and closing movement. Any pathology of both the articular disc, the mandibular condyid or the dental occlusion can affect the temporomandibular joint. This will generate different types of pathologies, different symptoms and different affectations.
Which people are more predisposed to have the pathology of the temporomandibular joint (TMJ)?
The pathology of the temporomandibular joint is associated with people who have pathological mandibular or joint movements. It has a lot of association with anxiety syndromes and stress syndrome and something we call bruxism that generates joint wear in a continuous and constant. It is also true that people who have alterations in both the jaw and maxillary bones are predisposed to suffer from this pathology. It is a very frequent pathology in the population in general and can have different types of severity and intensity in its affectation.
What symptoms appear when you have this disease?
The most characteristic symptomatology and the one that most come to us is joint pain. What the patient really refers is not an articulation pain but a periauricular pain, therefore the first specialist he comes to is the otorhino who explores the auditory canal and discovers that he has no pathology whatsoever and, therefore, he refers it to us. This pain is very characteristic, usually appears early in the morning and is usually calm throughout the day. Another type of symptomatology that is also very common is the joint snap. This atrial click is usually audible on the part of the patient and sometimes, even audible by its surroundings, it is usually annoying and uncomfortable because it is usually generated at lunchtime. Another characteristic symptomatology of the temporomandibular joint is joint blockage, difficulty opening the mouth. This usually appears in a high percentage of patients and characteristically is higher early in the morning and decreases throughout the day. Another of the symptomatology, the most striking that we find and which is primarily of emergencies, is the temporomandibular dislocation. This dislocation makes the patient go to the hospital with his mouth open and impossible to close. This pathology often requires sedation and even emergency treatment.
What treatments are there to combat the pathology of the temporomandibular joint (TMJ)?
The treatment of the temporomandibular joint must be a multidisciplinary treatment. Which will require treatment by the dentist, the phyteotherapist and osteopath and the maxillofacial surgeon. The most usual and most conventional treatment is the treatment by means of discharge splint and phyisotherapy. This treatment must be coordinated and requires direct control by the maxillofacial surgeon. Another of the most common treatments is arthrocentesis or joint washing. What we achieve with this treatment is to release the disc, reposition it and hydrate the joint. We also have the possibility of doing an arthroscopy with which we can do any type of internal treatment in the joint by retouching or repositioning the articular disc. The last possibility of treatment is open surgery , which is used in very complex cases and in cases in which we need to completely change the joint.