Temporomandibular Joint Disorders – Diagnostic, Therapy

Dysfunctional Disorders

Normal functional activity

Adaptive Function

Parafunctional Disorder

Muscle Disorders

Reflex muscle splinting
Trismus or myospasm
Myofascial pain or trigger pain syndrome
Myositis
Contracture
Hypertrophy
Neoplasms

Disc Interference Disorders

Disc Displacements
Disc Dislocation with spontaneous reduction
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.