Disc Displacement Of The Inner Tmj

The most common form of the disc displacement of the inner jaw joint is an anterior misalignment or displacement of the articular disk above the condyle. Symptoms include localized joint pain and cracking in jaw movement. Diagnosis is based on history and physical examination. Treatment includes analgesics, by immobilizing the jaw, muscle relaxers, physical therapy and splints. If these methods fail, surgery may be required. Early treatment improves the results enormously.

The upper head of the lateral pterygoid is the articular disc pull out of its normal anterior position when abnormal jaw movements cause spasms. Abnormal jaw movements may be due to congenital or acquired imbalances or the sequelae of trauma or arthritis. If the disc remains in the anterior position, it is called a displacement without reduction. It comes to the mouth opening (lockjaw), and pain in the ear and in the TMJ region. If the discus at a point of the joint field trip returns to the head of the condyle, this is called displacement with reduction. A displacement with reduction occurs in about a third of the population at a particular point.

The most common form of the disc displacement of the inner jaw joint is an anterior misalignment or displacement of the articular disk above the condyle. Symptoms include localized joint pain and cracking in jaw movement. Diagnosis is based on history and physical examination. Treatment includes analgesics, by immobilizing the jaw, muscle relaxers, physical therapy and splints. If these methods fail, surgery may be required. Early treatment improves the results enormously. The upper head of the lateral pterygoid is the articular disc pull out of its normal anterior position when abnormal jaw movements cause spasms. Abnormal jaw movements may be due to congenital or acquired imbalances or the sequelae of trauma or arthritis. If the disc remains in the anterior position, it is called a displacement without reduction. It comes to the mouth opening (lockjaw), and pain in the ear and in the TMJ region. If the discus at a point of the joint field trip returns to the head of the condyle, this is called displacement with reduction. A displacement with reduction occurs in about a third of the population at a particular point. All kinds of displacement can cause capsulitis (or synovitis), an inflammation of the tissues surrounding the joint (e.g., as tendons, ligaments, connective tissue, synovial fluid). A capsulitis may also occur spontaneously or after arthritis, trauma or infection. Symptoms and complaints Displacement of the discus with reduction often causes a clicking or popping sounds when the mouth is opened. There can be, especially when chewing hard food pain. The patient’s joint noises while chewing are often embarrassed because they believe that others present to hear noise when they chew. What is actually sometimes the case even though the sounds to the person concerned seem louder than they are. A displacement of the disc without reduction usually causes no noise, but the maximum cutting edge distance between the upper and lower jaw in the mouth opening is reduced from typically 45 to 50 mm to ? 30 mm. General occur pain and a changed perception of the bite by the patient. It manifests itself usually acute in a patient with a chronic jaw click; in about 8 to 9% of cases, the patient is waking up not able to fully open the jaw. A capsulitis leads to localized joint pain, tenderness and occasionally to the mouth opening. Diagnosis Clinical Evaluation The diagnosis of displacement of the disc with reduction requires observation of the jaw when the mouth is opened. In opening the jaw of> 10 mm (measured between the upper and lower front teeth) is a click or crackle or to feel trapping when the disc springs back over the head of the condyle. Upon further opening of the condyle remains on the discus. Another, more subtle (reciprocal) can be heard cracking during jaw closure usually when the condyle slips over the back edge of the disc and the disc then slides forward. To diagnose the shifting of the disk without reposition the patient has to open his mouth as much as possible. The cutting edge distance is measured and then easily applied pressure to a little further to open his mouth. Normally, the thus measured mouth opening is about 45 to 50 mm, but with verlagertem Diskus only about ? 30 mm. Close or advancing the jaw against resistance increases the pain. An MRI is usually done to confirm the transfer of the disk or to determine why a patient does not respond to treatment. A capsulitis is often diagnosed based on a medical history injury or infection together with marked sensitivity to the hinge region and by exclusion, if the pain persist on myofascial pain syndrome, disc displacement, arthritis and structural asymmetries after treatment. However capsulitis may concomitantly be present in all of these mentioned diseases. Therapy analgesics as needed Sometimes non-surgical procedures such as training devices (z. B. passive jaw movement devices) or repositioning of the occlusal splints operation if conservative treatment fails In capsulitis sometimes corticosteroid injection A disk displacement with reduction requires no treatment, if the patient’s mouth without complaints can open far enough (about 40 mm or the width of the index, middle and ring fingers together). When occurring pain mild analgesics such as NSAIDs can be used (every 6 h 400 mg po ibuprofen). Some patients benefit from passive jaw movement exercises with commercially available mechanical devices. With a disease duration of <6 months anterior Repositionierungsschiene can be used to move the lower jaw forward and the discus. This track is a horseshoe-shaped device made of hard, transparent acrylate (plastic) which is made so that it fits exactly on the teeth of a jaw. Your chewing surface is designed so that the lower jaw is held forward when the patient bites onto the rail. In this position, the disc is always at the head of the condyle. The rail is gradually adjusted, so that the lower jaw can continue to move posteriorly. If the disc in the stretching of the upper portion of the lateral pterygoid muscle on the condyle remains, it is called that the disk is captured. The longer the disk displacement is, the stronger the discus is deformed and the less likely repositioning will succeed. A surgical folding of the discus can be done, however, with changing success. Disc displacement without reduction may require no treatment other than the prescription of analgesics. Rails may be helpful if the Discus articularis was not significantly deformed, but their long-term use can lead to irreversible changes in oral architecture. In some cases, the patient is instructed to stretch the discus slowly out of position, creating a normal mouth opening is possible. Various arthroscopic and open surgical procedures are available, if conservative treatment fails. A capsulitis is initially treated with NSAIDs, restraint of the jaw and muscle relaxation. Sometimes can be used for a short time a track that is worn at night or during the day, until the inflammation decreases. When these therapies are not successful, corticosteroids can be injected into the joint or arthroscopic flushing and cleaning of the joint to be performed. SUMMARY The discus is brought by abnormal articular jaw mechanism from its anterior position; he can remain displaced (without reduction) or return (with repositioning). Disc displacement with reduction typically causes clicking and pain during chewing. Disc displacement without reduction caused no click, but also reduces the maximum mouth opening to ? 30 mm. Surrounding tissue can be painful inflamed (capsulitis). Analgesics, reposition tracks and passive jaw movement test equipment are often helpful, but sometimes surgery is required.

Health Life Media Team

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