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Tmj Disorders

The Temperomandibular joint known as the TMJ, joint that connects the maxilla or upper jaw and the mandible or lower jaw situates at the base of skull in front of the ear. The joint has a round protrusion of the lower jaw that rests on an indentation in the skull & disc like structure which is made of a soft bone known as cartilage is found in between the two bones. This is known as ARTICULAR DISC. Ligaments that arise from various parts of the temperomandibular joint supports the jaw and helps in its movements. Several muscles that are connected to their ligaments, also helps in the movement of the jaw. Temperomandibular joint disorder can be referred to as any problem that occurs in the joints & movements.

TMJ can be fractured or become sore. Fracture is rarely seen, but the articular disc displacement is commonly seen.

SYMPTOMS

  • Severe pain & swelling.

  • Limited movement of the lower jaw

  • Radiating pain to the neck & head region

  • Severe headache which resembles migraine pain

  • Sharp ear ache

  • Clicking & popping sensation while opening or closing the mouth

  • Strong pain when tried to open mouth wide, to eat or to yawn

  • Locking of the jaws

IMPROPER ALIGNMENT OF TEETH OR JAWS AND GRINDING OF TEETH ARE THE COMMON CAUSES OF TMD ( TEMPERO MANDIBULAR DISORDERS ) In addition, the other Symptoms of TMD includes
  • Pain or tenderness in the face

  • Snoring and disturbed sleep

  • Pain around neck and shoulders

  • Popping sound in ears

  • Sleep APNEA

  • Hearing problem

  • Tooth aches

  • Restless Legs

  • Dizziness

  • Over all lethargy

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Diagnosis and Treatments

Each patient has to undergo a diagnostic set up - which includes

1.DIGITAL X-RAYS

  • Lateral cephalograph

  • OPG

  • TMJ view( left+right open &close)

  • Airway CBCT volumetry

  • 3D CT TMJ/ Airway

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2.QUESTIONNAIRE

3.INTRA-ORAL &EXTRA ORAL EXAMINATION

4.POSTURAL EXAMINATION

5.SLEEP STUDY (HST-HOME SLEEP TEST OR PSG –POLY SOMNOGRAPH)

TREATMENT

Treatment involves applying the ULF TENS (J5 MYOMONITOR )M –SCAN AND K7/JT ,the TMJ specialist would register the perfect bite of the patient and a customized ANATOMIC ORTHOTIC ( ORAL APPLIANCE ) to maintain the new mandibular position which would relax the muscles and would repair the temperomandibular joint . The patient has to wear the appliance for 8-10 months which includes bi monthly visits to the doctor (if required) for orthotic (appliance) adjustments. The pain and the associated symptoms would reduce in one week to two weeks time and by the end of the treatment time, the patient will not have any of the symptoms associated with temperomandibular disorders (TMD).This is the first phase of treatment.

The Second phase of treatment includes ORTHODONTIC OR PROSTHODONTIC REHABILITATION to maintain the corrected bite and jaw position in the patient permanently to avoid the relapse of the pain.

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