Temporomandibular Joint Disorders – Diagnostic, Therapy

=Dysfunctional Disorders=

Disc Dislocation without reduction
=Internal Joint Derangement=

Causes

 * Effusions and hemarthroses
 * Structural abnormalities of the articular surfaces
 * Intracapsular Adhesions
 * Arthropathies (Inflammatory diseases, Osteoarthritis, crystals depositions arthropathy)

=Mobility Disorders=

Ankylosis
Stiffening/Fixation of a joint as the result of a disease process with fibrous or bony union across it.

Causes

 * Childhood Trauma
 * Arthritis
 * Joint Infections
 * Tumors
 * Mastoid Disease

Recurrent Mandibular Dislocation
Displacement of 1 component of the joint beyond its normal limits without spontaneous return to its normal position.

=Diagnostics= Arthroscopy: Insert sheath w/ a trocar into the joint. Replace trocar w/ scope. Illuminate the joint fiberoptically. Irrigate the joint cia the sheath and an eyresis cannula. View the joint via camera attached to the scope. SOmetimes instrument the joint via a 2nd part. Adv: Min invasive. Disadv: Limited Scope for reconstructive surgery, requires high level of operator skill. Comps: Failure to enter joint cleanly. Phys injury to joint capsule and or joint surfaces. Bleeding along entry tract apply pressure. Scope maybe misdirected towards EAM or up towards middle cranial fossa.

=Therapy=

Arthropcentesis. Def: Aspiration of fluid drom a joint through a needle.

Total Replacement of TMJ: Expensive and no easy scape if unsuccessful and symptoms continue therefore last resort.