Temporomandibular joint dysfunction- causes, symptoms, diagnosis, treatment, pathology

Temporomandibular disorders are a group of
disorders that all involve the temporomandibular joint, which is located between the temporal
bone of the skull and mandible, or jawbone; and the muscles and associated structures
that are involved in chewing and speech. Normally, between the temporal bone and the
mandible is a synovial cavity, which is wrapped in fibrocartilage and filled with synovial
fluid, which is a protein rich fluid that reduces friction between the sliding bones. The synovial cavity is divided into an upper
and lower compartment by an articular disc within the synovial fluid. The lower compartment is bound, inferiorly,
by the condylar head of the mandible. The lower compartment allows the mandible
to rotate, which lets the mouth open and close. The upper compartment is bound, superiorly,
by two regions of the temporal bone: the mandibular fossa, in the middle and back, and articular
tubercle, in the front. Separating these two compartments is the articular
disc. The upper compartment allows the condylar
head to move forward and rotate. The movements of the temporomandibular joint
are coordinated by numerous muscles, including: the temporalis, a fan-shaped muscle on both
sides of the cranium; the masseter, which connects to the mandible and the zygomatic
arch of the temporal bone; the medial pterygoid, which connects to the mandible and medial
pterygoid plate; and the lateral pterygoid, located at the condylar process. These muscles are innervated by branches of
the trigeminal nerve. Now, the causes of temporomandibular disorders
can be categorized as intra-articular, within the joint, or extra-articular, involving the
surrounding musculature. Intra-articular causes, are called temporomandibular
joint disorders, and they include things like abnormalities of the bones in the joint, inflammation
in the joint from conditions like osteoarthritis or rheumatoid arthritis; disorders of the
articular disk; laxity of the fibrocartilage allowing for temporomandibular hyper or hypo-mobility;
or trauma that might result in structural damage or bleeding inside the joint. Extra-articular causes, are also called temporomandibular
muscle disorders, and they include things like overuse of the masticatory muscles, like
in bruxism, which is teeth grinding or jaw clenching; as well as chronic muscle spasms
or muscle inflammation. The main symptom of temporomandibular joint
disorder is pain or tenderness, especially with movement of the jaw – like when chewing. The pain can also radiate causing headaches,
toothaches, and earaches. It can also cause jaw dysfunction and limited
range of jaw motion, where the jaw catches or locks in a certain position. There can also be clicking or popping noises
when moving the jaw, as well as jaw deviations. Because of the various causes and types of
temporomandibular disorders, a diagnosis requires keen observation, especially around factors
that cause or worsen the problem. It’s helpful to measure the range of jaw
motion, listen for irregular sounds like clicking and popping, and feeling for areas of tenderness. Plain radiographs and CT scans can show structural
abnormalities or trauma; and MRIs can show changes in the articular disk and evidence
of joint inflammation. Treatment of temporomandibular disorder is
based on the underlying cause, but the initial goal is to help reduce pain and restore normal
jaw function. Pain can be reduced by applying moist heat
or cold compresses, as well using massage, resting the muscles by eating a softer diet,
and avoiding strain on the jaw, like dental work or biting on objects. Physical therapy involving jaw exercises can
help with pain and range of motion. Oral appliances, like splints, can reduce
the effects of nocturnal bruxism, and cognitive-behavior therapy can address behaviors and underlying
psychiatric illnesses that worsen temporomandibular disorders. Medications like muscle relaxants and non-steroidal
anti-inflammatory drugs can also be used to help with pain control. In rare situations, arthroscopy can be done
– which is when a small thin tube with a camera is placed into the joint space, to both diagnose
and treat the condition. Finally, in cases where there’s a structural
defect, surgery may be needed. Alright, as a quick recap, temporomandibular
disorders are a group of musculoskeletal disorders that result from dysfunction in the temporomandibular
joint or masticatory muscles controlling the jaw. The result is jaw pain and tenderness. A key goal of treatment is to reduce pain
– and this can be done with relaxation of the jaw, as well as managing underlying problems
like bruxism with oral appliances, and the use of pain medications.

21 comments

  1. thanks for your Fantastic videos upload more there is people who can't pay for the premium but we can make for you 1 billion like .pleas pleas#algeria

  2. If you pop your jaw the discomfort is released. And remember kids every lady who told you not to pop your knuckles 30 years ago is riddled with arthritis and you are not.

  3. you went through the entire video without mention of costen's syndrome. We are not studying literature, we are studying medicine.

  4. Wow thats spooky, i've been using this site for ages and in the last few weeks I got diagnosed with TMJ Dysfunction – weird to see it pop up on my subscriber videos, thanks – it helps a lot !

  5. thank you so much
    but, medial pterygoid muscle is connected to the medial aspect of LATERAL pterygoid plate

  6. zero mentions of any aromatherapy or alternative treatments… zero mentions of damaging toxins and sugary foods with bad fat which lead to chronic disease… no mention of material science of bone formation or muscle formation and the compounds and vitamins which have to do with joint dysfunction

    still like the video, but come on…you can do way better

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