Infectious arthritis, traumatic arthritis, osteoarthritis, RA and secondary degenerative arthritis can affect the function of the temporomandibular joint.
Infectious arthritis, traumatic arthritis, osteoarthritis, RA and secondary degenerative arthritis can affect the function of the temporomandibular joint. Infectious arthritis Infection of the temporomandibular joint (TMJ) can be prepared by direct extension of an adjacent infection or hematogenous spread of pathogenic microorganisms formed (acute infectious arthritis; Acute infectious arthritis). The area is inflamed and limited the mobility of the jaw. Local signs of infection associated with evidence of a systemic disease or an adjacent infection lead to the diagnosis. Radiographic findings are negative in the early stages but may later show a bone destruction. If a purulent arthritis is suspected, the joint is punctured to confirm the diagnosis and to identify the causative pathogen. The diagnosis must be made quickly to prevent permanent joint damage. Treatment includes antibiotics, proper hydration, pain control and restricted movement. Parenterally administered penicillin G is the drug of choice until the basis of culture and sensitivity testing a specific bacteriological diagnosis can be made. Purulent infections are aspirated or incised. Once the infection is under control, assist mouth exercises to avoid scarring and limitation of movement. Traumatic arthritis In rare cases can cause an acute injury (eg., By a difficult tooth extraction or endotracheal intubation) to an arthritis of the temporomandibular joint. It occurs pain, tenderness and limitation of movement. The diagnosis is based primarily on history. Radiographic findings are negative, except when an intra-articular edema or intraarticular hemorrhage widens the joint space. The treatment includes NSAIDs, application of heat, soft diet and restricted movement of the jaw. Osteoarthritis The TMJ may be affected, usually in patients aged> 50 years. Occasionally, patients complain of stiffness, creaking or scratching sounds or slight pain. The crepitus is based on a formed through hole in the wear disc, thereby scrapes bone to bone. In general, both joints are affected. X-rays or CT can show a flattening and a reduction of the condyle, suggestive of dysfunctional change. The treatment is symptomatic. (Which can lead to the fact that the jaw when biting longer close) a face mask that is worn during the night or during the day can help relieve pain and reduce crunching noises in patients with missing teeth. Rheumatoid arthritis The temporomandibular joint is at> 17% of adults and children (RA) with rheumatoid arthritis affected, but usually involves having the last joint. Pain, swelling and limited mobility are the most common findings. In children, the destruction of the condyle to disturbances of mandibular growth and facial deformities leads. Ankylosis can follow. The radiographic findings of TMJ are negative usually in the early stages but later show a bone destruction that can lead to an anterior open bite. The diagnosis is based on the inflammation of the temporomandibular joint in conjunction with polyarthritis and is confirmed by other, typical of the disease findings. The treatment is similar to that of RA in other joints (rheumatoid arthritis (RA) treatment). In the acute stage NSAIDs may be administered, and the jaw function should be restricted. A mouth guard or a splint worn at night, is often helpful. If symptoms resolve, light pine exercises can help to avoid excessive loss of mobility. Surgery is necessary if ankylosis develops but should not be carried out before the disease has stopped. Secondary degenerative arthritis This type of arthritis develops usually in patients aged 20 to 40 years after a trauma or in patients with persistent myofascial pain syndrome (myofascial pain syndrome). Its main features are limited mouth opening, one-sided pain in jaw movement, tenderness of the joint and crepitus. If this arthritis is connected to a myofascial pain syndrome, come and go the symptoms. The diagnosis is based on X-rays, which typically show a flattening, forming, osteophytes or erosion of the condyle. Unilateral joint involvement helps distinguish between secondary degenerative arthritis and osteoarthritis. Treatment is conservative, as in myofascial pain syndrome, although arthroplasty or high condylectomy may be required. An occlusal splint (mouth guards) relieves the symptoms usually. The rail is always worn, except during meals, oral hygiene or cleaning thereof. If symptoms resolve, the daily wearing time of the track is gradually reduced. An intra-articular injection of corticosteroids may relieve symptoms, but damage the joint with frequent repetition.