TMJ SYMPTOMS AND CAUSES

TEMPOROMANDIBULAR SYMPTOMS AND CAUSES

 

Temporomandibular issues embrace a wide range of explicit and vague problems that produce indications of agony and brokenness of the muscles of rumination and temporomandibular joints.

 

Temporomandibular Joint Dysfunction is applied in a more limited sense to more modest bunch of related, moderately vague problems of TMJ and muscles of rumination that share numerous side effects practically speaking.

 

 SYMPTOMS OF TMJ DYSFUNCTION

The commonly occurring symptoms are:

1)      Pain.

2)      Joint sounds.

3)      Limitation of mandibular movements.

4)      Ear symptoms.

5)      Recurrent headache.

 

1)   Pain:

 

·      Pain felt in muscle is called myalgia.

·      Two principle components of myogenic torment are:

1)  Mechanical injury,

2)  Muscle weakness.

 

Ø Mechanical injury:

·      Macro trauma emerges from an outer power like hit to the face.

·      Microtrauma emerges without outer power and is ordinarily connected with parafunction like bruxism.

 

Ø Muscle weariness:

·      Sustained static muscle constriction can cause limited ischemic and a modification in muscle fibers layer porousness that outcomes in neighborhood edema.

·      Localized delicate spaces of muscle which might be related with firm groups or bunches of muscles are known as trigger focuses and is named myofascial torment.

·      Myogenic torment is a sort of profound torment and in the event that it becomes consistent can create focal excitatory impacts which may present as alluded torment, optional hyperalgesia or even autonomic impacts.

 

Ø Articular torment

·      It can emerge because of irritation of articular and periarticular tissues brought about by over-burdening or injury to those tissues.

·      These are usually connected with breakdown made by weighty occlusal powers to the teeth and their strong constructions.

 

a)   Mobility:-

·      Due to deficiency of bone help

·      Heavy occlusal powers.

·      Loss of bone help is principally because of periodontal sickness.

·      When substantial level powers are applied deep down, the pressing factor side of the root gives indications of rot and inverse side gives indications of vascular widening and prolongation of periodontal tendon. This builds the width of periodontal space on the two sides of the tooth which is at first loaded up with granulation tissue which changes steadily to collagenous and sinewy connective tissue. This expanded width caused expanded versatility.

 

b)   Tooth wear:

 

·      This is seen as gleaming level spaces of the teeth that don't coordinate occlusal type of tooth. This space of wear is called wear feature, the aetiology stems on the whole from parafunctional and not-useful exercises.

2.   Joint Sounds :-

 

There are two sorts of joint sounds:

 

           I.    Crepitus :-

·      This is a grinding or scratching commotion that happens on jaw development which can be seen by the patient and regularly can be touched by the clinician. It is said by the patient to feel like sand paper scouring together. It is brought about by roughened, sporadic articular surfaces of the osteoarthritic joint.

 

         II.    Clicking :-

This is brought about by awkward development of condylar head and TMJ circle.

 

Ø Reasons for TMJ clicking (Klienberg, 1991)

 

·      Brokenness:

1.    Click related with deviation in type of condyle, circle and worldly fossa.

2.    Click related with neuromuscular brokenness.

3.    Eminence snap.

4.    Click (corresponding) with front plate uprooting.

5.    Click related with hypermobility.

6.    Teethered plate click.

 

·      Cause:

1. Remodeling and morphologic changes of the articular surfaces and plate holes may give mechanical deterrent to condylar interpretation.

2. Uncoordinated development might be because of brokenness of controlling muscles, the horizontal pterygoid or masseter muscles.

3. Eminence click happens in relationship with a constrained joint opening with a protrusive opening curve. This can happen unknowingly for instance with Class II impediment or as a deliberate development.

4. The antero-superior a piece of the mandibular condyle is regularly identified with focal fossa of the plate. The circle now and again anyway may get dislodged. Front uprooting of the circle in the joint space makes a tick happen as the condylar head gets across the back edge of the plate. This happens both on opening and shutting developments of the mouth. A double tap is subsequently delivered and is alluded to as proportional clicking. This condition may advance to shut clock when head of condyle gets unfit to pass across back edge. This will bring about restriction of opening of mouth.

5. Hypermobility click happens when the top of the condyle clicks over the foremost edge of the plate when the mouth is totally open.

6. Teethered plate click. A back plate connection that has been harmed because of injury may forestall the interpretation of TMJ circle that ought to happen on opening the mouth. Corresponding clicking may happen as the top of the condyle disregards the foremost band of the meniscus on opening and shutting the mouth.

3)   Limitation of mandibular development 

Ø Muscular limitation:

The limitation is brought about by withdrawal in a gathering of muscles and can be delivered by strong extending of muscle or its synergists or as a reaction to torment, either in the muscle or its synergists, or around the joint. Challenges in opening the mouth after convoluted tooth extractions and mandibular nerve squares may be brought about by reflex solid restraint or intramuscular discharge. 

Ø Disc relocation : shut lock:

An anteriorly dislodged circle may forestall the forward interpretation of the mandibular condyle which brings about restriction of opening of the mouth, for example shut lock. Clinical signs are diminished opening limit, mandibular deviation on opening and delicacy to palpation of the influenced TMJ. The early or intense shut lock may result in interincisal opening of under 35mm.

Ø Ligamentous Restrictions: 

In some cases tendons become extended and along these lines hypermobility results with conceivable sequele for example disengagement of the joint instead of limitation of development. the sphenomandibular tendon can once in a while be too short to even think about allowing an ordinary mouth opening limit. 

Ø Dislocation:

On wide opening of the mouth the top of the condyle ordinarily ignores the articular greatness infrequently a patient might be not able to close the mouth on the grounds that the condyle can't return into the fossa. The mouth will be totally open and a sensation of frenzy is noticed.

4)   Ear manifestations:

 Abstract ear indications are regularly connected with TMJ brokenness. Indications incorporate tinnitus, tingling in the ear, an impeded inclination and dizziness. The indications are most likely because of utilitarian unsettling influence of the Eustachian tube. The masseter hyperfunction may prompt vibration and clones of tensor tympani muscle which is additionally innervated by trigeminal nerve.

5)     Recurrent cerebral pain

 It habitually goes with torment and delicacy in the masticatory muscles. Bruxism can create fleeting cerebral pain without other emotional side effects however the worldly muscle is then typically delicate to palpation and is regularly an indication of summed up pressure identified with a related uneasiness state.

Here is a great link to help you to Know about Anatomy of TMJ. https://drshreyanagrawal.blogspot.com/2021/05/temporalmandibular-joint-introduction.html

Finally, with regards to Provide information on TMJ Symptoms and causes. 

I trust you keep on discovering these web journals supportive if just to assist you with growing your Knowledge!

DR. SHREYAN AGRAWAL

(PROSTHODONTIST)