Arthritis of temporomandibular joint

An acute or chronic inflammatory disease of the structural elements of the joint of the temporal and mandibular bone, which is accompanied by a functional disorder isarthritis of the temporomandibular joint.

According to statistics, people of young age and middle age are more often ill. A common disease is characterized by inflammation of the joint capsule and connective tissue of cartilage, and In the future, bone ankylosis, muscle contractures, joint atrophy, deforming arthrosis.

Causes

The main causes that cause the development of the disease:

• injuries sustained over a lifetime,
• local infectious diseases (stomatitis, osteomyelitis, gingivitis, otitis, tonsillitis)
• common infections (tuberculosis, influenza, syphilis, pneumonia),
• presence of foci of chronic infection,
• allergic reactions.

Types of arthritis of the TMJ

Inflammation in the joint can develop rapidly, but can with a gradual increase in the clinic. It depends on the cause of the disease and on the ability of the body to resist the effects.

There are several types of the disease:

1. Traumatic. Is a consequence of a fall or a blow. This form of the disease manifests itself immediately. It is characterized by acute pain, swelling, restriction of movements of the lower jaw and displacement of the chin to the side. Often, there is swelling, rupture of ligaments and a hemorrhage into the joint capsule, which leads to ankylosis. On the roentgenogram, an abnormally widened articular fissure is visible.
2. Infectious(specific and nonspecific). It arises from the entry of microbes into the joint cavity. Usually the disease manifests as a complication of otitis media, influenza, angina, mastoiditis, osteomyelitis of the lower jaw. Often there is a disease due to rheumatism or rheumatoid arthritis. Characteristic indicators are acute onset and severe pain in the movement of the lower jaw, extending to the ears, neck, tongue, nape, hyperemia, edema, and a strong crunch.

• Specific. The disease has acute and chronic course. It develops as a result of the presence in the body of a chronic infection (tuberculosis, gonorrhea, actinomycosis, syphilis, leprosy). Symptoms are severe, and secondary infection is often associated: fistulous passage, gum in the periarticular tissues, contracture of the chewing muscles and lower jaw. It is relatively rare.

By the method of penetration of the infection into the joint cavity, hematogenous and contact are distinguished. And the nature of the inflammatory process in the joint is divided into acute and chronic forms.

Symptoms of the disease

Symptoms of acute arthritis of the temporomandibular joint:

1. Violation of the process of movement in the lower jaw and a feeling of stiffness, especially in the morning.
2. One-sided pain of a local or pulsating nature in the region of the joint, of varying duration and strength, radiating into the temple, sometimes into the ear and tongue.
3. An acute onset of the disease.
4. Violation of speech and masticatory function.
5. Limited opening of the mouth 1
6. Discomfort and soreness in joint palpation.
7. Displacement of the lower jaw with opening of the mouth, towards the inflamed joint and asymmetry of the face.
8. Articulation (clicking, rustling, crunching)
9. Formation of densification and hearing impairment.
10. Edema, hyperemia in the joint area and swelling on the side of the lesion in the ear.
11. High temperature and symptoms of a general patient's condition.

The symptomatology of chronic arthritis is different:

1. There is no temperature increase, the general condition is satisfactory.
2. Painful and pulling character, which is strengthened when the jaw moves and when you press the chin, stiffness and stiffness in the joint.
3. Intense crunch in the joint, tinnitus, glossalgia.
4. The opening of the mouth takes place 2-3 cm.
5. Visually, there is no change in the area of ​​the joint, but the examination reveals deformation of the joint head, which leads to dislocation of the lower jaw.

At this stage of the disease, there are:

• phenomenon of fever,
• the formation of an infiltrate,
• in the joint region the formation of an infiltrate,
• acute pain,
• hyperemia of the skin,
• hyperesthesia,
• dizziness and hearing loss,
• On the roentgenogram, an enlarged articular cleft is visible.

The onset of a purulent form is acute, the blood is elevated with ESR and leukocytosis. Among the complications are sepsis, fistula, ankylosis.

The most common methods of treatment

An important point in the beginning of treatment is the diagnosis of the TMJ. To this, rheumatologists, dentists, phthisiatricians, traumatologists, otolaryngologists are involved, since the disease requires differential diagnosis with arthropathies, trigeminal neuralgia and other diseases.

The main method of diagnosis is a computer tomography or radiography.In the picture, the main determining sign of an acute subspecies is the enlargement of the joint gap, with chronic disease - narrowing, the appearance of the articular tubercle and marginal articular patterns heads.

Any form requires a complex of necessary measures, an individual syndrome of the approach to treatment and depends on the degree and nature of the disease.

The goal of the treatment is the rapid cessation of the pain syndrome, the rapid resolution of blood in the joint, the restoration of the functioning of the jaw.

The general scheme includes:

1. The use of antibacterial therapy (taking into account the sensitivity of microflora) and analgesics.
2. If there is inefficiency, use of surgical intervention.
3. Vasodilator drugs.
4. Immobilization of the jaw, by using an individually manufactured bandage bandage and using an interdental plate to ensure complete resting of the joint.
5. Stimulation of immunological activity.
6. Help doctors of different profiles, exercise therapy.
7. A diet rich in vitamins.
8. Ethnoscience.

The traumatic form of arthritis of the temporomandibular joint is treated with the use of a special individually a chosen bandage or a tire on the lower jaw, to separate the occlusion - the interdental plate, diet.

All activities are aimed at relieving pain and restoring the motor activity of the jaw. The first few days showed the use of analgesics and non-steroidal anti-inflammatory drugs, cold compresses, physiotherapy procedures (Bernard's diadynamic currents, electrophoresis, UHF, paraffinotherapy). Often in such cases, use miogimnastiku - dosed daily opening of the mouth, without movement of the jaw.

Treatment of infectious arthritis is carried out in a complex and conservative way. In complex treatment, anti-inflammatory drugs (naproxen, voltaren, ibuprofen, indomethacin), antibiotics (ceftriaxone, lincomycin, cefuroxime, latamoxef), steroid (dexamethasone, cortisone, nazacort, synalar), desensitizing (dimedrol, tavegil, suprastin), biogenic stimulants (aloe, FIBS).

Treatment of purulent arthritis of the TMJ is performed by surgical intervention. The autopsy and drainage of the inflammatory focus, antibiotic therapy, physiotherapy procedures are shown.

In the treatment of patients with specific arthritis of the TMJ, a direction is being taken to eliminate the underlying disease and is performed by specialists of the appropriate profiles.

Methods of prevention

For the purpose of prophylaxis of the TMJ, experts recommend correcting an incorrectly formed occlusion, caries prevention, timely treatment and prevention of infectious diseases, exercise gymnastics, a healthy way of life, food.

After the course of treatment - bandages with decoction decoction, oak bark, calendula and chamomile, compresses with bee venom. These procedures soothe and warm the sick joint.

Timely begun and correct treatment leads to complete recovery.