Difficulty opening mouth
Introduction
Introduction The difficulty of opening the mouth is the clinical manifestation of Temporo-mandibular Joint Dysfunction Syndrome, also known as Temporomandibular Joint Syndrome, and 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 temporomandibular joint disorder syndrome occurs mostly in young adults. 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.
Cause
Cause
The temporomandibular joint disorder syndrome occurs mostly in young adults. 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.
1. Trauma factors: Many patients have a history of local trauma. Such as the impact of external forces, sudden biting hard objects, excessive mouth opening (such as yawning) and other acute trauma; there are often chew hard food, night molars and unilateral chewing habits. These factors may cause joint contusion or strain, and the dysfunction of the masticatory muscle group may also have an effect on the occurrence of this disease.
2. Bite factors: Many patients have obvious occlusion disorders. Such as excessive cusp, excessive tooth wear, excessive tooth loss, poor dentures, and low distance between jaws. The disorder of the occlusal relationship can destroy the balance of functions between the internal structures of the joints and promote the occurrence of this disease.
3. Systemic and other factors: neuropsychiatric factors may have a 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.
Examine
an examination
Related inspection
Temporomandibular joint examination of temporomandibular joint angiography, bone and joint and soft tissue CT examination
According to the medical history, it is not difficult to diagnose the temporomandibular joint disorder syndrome with the above main symptoms. Common methods for assisted diagnosis are:
1X line plain film (synaptic Xue's position and sacral process through the pharyngeal side), can be found in joint space changes and bone changes, such as sclerosis, bone destruction and hyperplasia, cystic changes.
2 joint angiography (upper cavity 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 have used arthroscopy to detect early changes in the disease, such as articular disc and synovial congestion, oozing, adhesion, and "articular rat" formed by undifferentiated mature cartilage-like tissue.
Because there are many types of this disease, the treatment methods vary. Therefore, a specific type of diagnosis should be made. Such as pterygoid tendon, reversible disc displacement or joint disc wear.
Diagnosis
Differential diagnosis
Since many of the other three diseases are also common in many other diseases, they must be identified with the following diseases:
Otogenic disease
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.
2. Styloid process
In addition to pharyngeal pain and paresthesia during swallowing, it often causes pain in the posterior condylar region and pain in the posterior region of the posterior region, the posterior region of the ear and the neck. X-ray examination is easy to diagnose.
3. rickets close the jaw
If the rickets are tightly closed, such as with other muscle tendons or convulsions, the diagnosis is easier. This disease occurs mostly in young women. It has a history of rickets and unique personality traits. It usually has mental factors in the onset of the disease, and then sudden opening difficulties or closed jaws. This disease often works with linguistic cues or indirect cues (using other treatments combined with language cues).
4. Tetanus teeth are closed
Tetanus is an acute specific infection characterized by myoclonic spasm and tonic contraction caused by tetanus. Since the initial condition can be manifested as difficulty in opening or closed jaw, the dental department should be diagnosed with the temporomandibular joint disorder syndrome, so as not to delay the timing of early treatment. Tetanus teeth are closed and generally have a history of trauma. usually starts from the masticatory muscles, first the chewing muscles are a little nervous, that is, the patient feels that the opening is limited; then the tonic sputum is closed and the jaws are closed; at the same time, the facial expressions are special due to the tightening of the expression muscles, forming a smiley smile face. With facial muscle twitching.
