temporomandibular joint disorder syndrome
Introduction
Introduction to temporomandibular joint disorder syndrome Temporo-mandibular Joint Dysfunction Syndrome Temporomandibular joint disorder syndrome is one of the common diseases in the oral and maxillofacial region. This disease is most common in temporomandibular joint diseases. Occurs in young adults, with the highest prevalence rate of 20 to 30 years old. The pathogenesis is not fully understood. The main features of this disease are soreness and pain in the joint area, ringing during exercise, and mouth movement disorder. Most of them have joint dysfunction and good prognosis; but in very few cases, the quality of the generator can also be changed. basic knowledge The proportion of illness: 0.001% Susceptible people: good for young adults, with the highest prevalence rate of 20 to 30 years old Mode of infection: non-infectious Complications: tinnitus
Cause
Causes of temporomandibular joint disorder syndrome
The temporomandibular joint disorder syndrome occurs mostly in young adults, and its pathogenesis is not fully understood. The main features of this disease are soreness and pain in the joint area, squeaking during exercise, and dyskinesia in the mouth. Most of them are joint dysfunction and have a good prognosis; In very few cases, the quality of the generator can also be changed.
Trauma factor (35%):
Many patients have a history of local trauma, such as acute trauma caused by external force impact, sudden biting hard objects, excessive mouth opening (such as yawning); frequent chewing hard food, night molars and unilateral chewing habits, etc. These factors may cause Joint contusion or strain, dysfunction of masticatory muscle group also has an impact on the occurrence of this disease.
Occlusal factor (30%):
Many patients have obvious occlusal disorders, such as excessive cusp, excessive tooth wear, excessive tooth loss, poor dentures, low distance between jaws, and occlusal disorders, which can disrupt the balance of function between internal structures of joints. To promote the occurrence of this disease.
Neurological factors (20%):
Neurological factors may have a certain relationship with the disease. For example, some patients have emotional irritability, nervousness, and excitement. In addition, some patients have a history of rheumatism, and some are related to cold.
Prevention
Temporomandibular joint disorder prevention
This disease is often caused by a combination of factors, and mental and psychological disorders, relationship disorders, bad oral habits, therefore, the key to prevent this disease is to regulate the pace and order of life, reasonable diet, keep the mouth clean, exercise, regular oral examination, It is especially important to treat abnormalities in early treatment. For those who are ineffective in active treatment, they should be highly alert to malignant tumors in the mouth and ears.
Complication
Complications of temporomandibular joint disorder syndrome Complications, tinnitus
The main clinical manifestations of this disease are joint pain, limited mouth opening, joint bounce, masticatory muscle soreness, chewing weakness, but also complicated with facial pain, tinnitus, dizziness and other systemic symptoms, most of which are joint dysfunction, good prognosis; It can be caused by structural disorder or organic destruction, and patients with dysfunction can develop into joint structure disorder and even organic damage in the later stage.
Symptom
Temporomandibular joint disorder syndrome Symptoms Common jaw joint pain, dizziness, tinnitus, ankle pain
The main clinical manifestations of temporomandibular joint disorder syndrome are local soreness or pain, squeaking and movement disorders. The painful part can be around the joint area or joints; it can be accompanied by tenderness of varying degrees of weight, joint swelling or pain. It is obvious when chewing and opening the mouth. The sound occurs when the mouth is open. The sound can occur at different stages of the jaw movement. It can be a crisp single or broken sound. The common obstacles to movement are limited, but it can also occur. When the mouth is too large or the mouth is open, the mandible is skewed. In addition, it may be accompanied by ankle pain, dizziness, tinnitus and other symptoms.
Examine
Examination of temporomandibular joint disorder syndrome
Common methods for assisted diagnosis are:
1X line plain film (synaptic Xue's position and sacral process through the pharyngeal lateral position), can be found to have joint space changes and bone changes, such as sclerosis, bone destruction and hyperplasia, cystic changes.
2 joint angiography (upper luminal angiography is easy to use and easy to use, lower luminal angiography is less domestic application), can find joint disc displacement, perforation, joint disc attachment changes and cartilage surface changes, in recent years, many scholars apply Arthroscopy can detect early changes in the disease, such as articular disc and synovial congestion, oozing, adhesions, and "articular rats" formed by undifferentiated mature cartilage-like tissues. Because of the many types of this disease, treatment The methods vary.
Diagnosis
Diagnosis and diagnosis of temporomandibular joint disorder syndrome
diagnosis
Diagnosis can be made based on medical history, symptoms and related tests.
Differential diagnosis
Tumor
Deep maxillofacial tumors can also cause difficulty in opening or tightness of the jaws, because the tumor is not easily detected in the deep part, and is misdiagnosed as a temporomandibular joint disorder syndrome, and even improper treatment has lost the opportunity for early radical cure of the tumor. If there is difficulty in opening, especially if you have symptoms of cranial nerves or other symptoms at the same time, you should consider whether there are tumors in the following areas: 1 benign or malignant tumor of the mandibular joint, especially condylar chondrosarcoma, 2 lower fossa Tumor, 3-wing axillary tumor, 4 posterior wall of maxillary sinus, malignant tumor of 5 salivary glands, 6 nasopharyngeal carcinoma, etc.
2. Temporomandibular arthritis
1 acute suppurative arthritis of temporomandibulor joint, the joint area can be seen red and swollen, tenderness is obvious, especially can not up and down, a little exertion can cause severe pain in the joint area.
Two types of rheumatoid arthritis of temporomandibular joints, often accompanied by systemic migratory, multiple arthritis, especially the lower extremities of the limbs are most often involved, joint stiffness can occur in the late stage.
3. Otogenic diseases
Inflammation of the external auditory canal and middle ear is also often transmitted to the joint area and affects the opening and chewing. Careful examination of the ear is not difficult to identify.
4. cervical spondylosis
It can cause pain in the neck, shoulders, back, back of the ear and side of the face, which is easy to be misdiagnosed, but the pain is not related to the opening and chewing, but often related to neck activity and posture, and some may have hand infection and abnormal movement. X-ray film can help diagnose cervical bone with or without bone changes for identification.
5. Stem overgrowth
In addition to pharyngeal pain and paresthesia when swallowing, it is often open, chewing can cause pain in the posterior condyle and post-joint area, pain in the posterior region of the ear and neck, X-ray examination, easy to diagnose.
6. Hysterical trismus
If the rickets are tightly closed and accompanied by other tendons or convulsions, the diagnosis is easier. The disease is mostly caused by young women. They have a history of rickets and unique personality traits. They usually have mental factors in the onset and then suddenly occur. Difficulty in opening or closed jaws, the disease often works with linguistic cues or indirect cues (using other treatments combined with language cues).
7. Tetanus teeth closed tightly (totanic trismus)
Tetanus is an acute specific infection characterized by myoclonic spasm and tonic contraction caused by tetanus. Since the initial condition can be characterized by difficulty in opening or closed jaw, it should be treated with stomatology. The mandibular joint disorder syndrome is differentiated so as not to delay the timing of early treatment. The tetanus has a history of trauma. The sputum usually starts from the masticatory muscles. First, the masticatory muscles are a little nervous, that is, the patient feels limited opening; The sputum is closed and closed; at the same time, the facial expression is special due to the tightening of the expression muscles, forming a "chat smile" face and can be accompanied by facial muscle convulsions.
