TMJ Surgery
The temporomandibular joint (TMJ) is the joint between the base of the skull and the lower jaw. In actuality, everybody has two TMJs, one on the right and one on the left, and when the jaw moves both joints move. TMJ disorders can be caused by several things including; trauma, malocclusion, stress, grinding the teeth, and skeletal growth deformity. Some systemic diseases such as rheumatoid arthritis can also affect the temporomandibular joints.
Two main categories of TMJ disorders exist: myofacial pain dysfunction and internal derangement of the temporomandibular joint. With myofacial pain dysfunction, patients may experience some associated neck and shoulder pain and muscle spasms originating in the temporal area or along the jaw line are usually related to some type of stress, trauma or malocclusion (bad bite). The treatment often involves physical therapy, muscle relaxants, and possibly a splint between the teeth in order to help relax the muscles and achieve a balanced bite. Further treatment may involve orthodontics and jaw surgery, or a crown and bridge to help stabilize the bite.
Inside the TMJ is a disc which slides on top of the articular head of the lower jaw as the mouth opens. It is possible for this disc to be displaced resulting in accompanying joint sounds such as popping and clicking. If the pops and clicks are accompanied by pain in the joint, it is usually a signal of degenerative changes. With internal derangement, associated muscle pain may occur, but usually pain exists directly in front of the ear, and patients find it beneficial to eat a soft diet. Usually, an MRI is needed in order to confirm the diagnosis of an internal derangement in the joint. Internal derangements, like myofacial dysfunction, can be treated with physical therapy, muscle relaxants, and splint therapy. If the conservative measures fail, TMJ surgery may be necessary.
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