Temporomandibular jointStructure. Role. Pathology
Located in front of the ears, on either side of the face, the temporomandibular joints join the mandibular bones to the cranial bones. They are also involved in the opening and closing motions of the mouth, as well as sideways movements.
The temporomandibular joint is frequently the location of pain that prevents the correct and complete performance of functional movements. It is a sensitive component of the dento-maxillary apparatus, its physiological activity being easily disturbed, even by stimuli considered to be minor.
Structure of the temporomandibular joint
It is predominantly bony but also contains vascular, muscular, ligamentous and nervous elements.
This is the main component of the temporomandibular joint; anatomically it separates the mandibular bone from the maxillary bone and interposes between these two components during mouth movements.
The disc has an elastic structure capable of supporting and absorbing a large amount of pressure generated especially during chewing. It is also what maintains harmony within the temporomandibular joint.
Dysfunction occurs if this coordination is lost.
Pain: anterior to the ear, it is usually sharp, throbbing, strong and can radiate to different levels of the face. The pain may also manifest itself in the form of migraines.
Sounds, noises perceived by the patient or by the people around: called cracks and crackles, and depending on when they occur in relation to the opening and closing of the mouth, it can be detected at which level the articular disc is affected.
Muscle tension: overstraining muscles and keeping them contracted for a long time can cause joint pathology. This is associated with a limitation of mouth opening, which is very uncomfortable for the patient. Any effort to open the mouth wider will produce increased pain intensity.
The reasons why the temporomandibular joint often suffers are varied and most of the time the pain occurs as a combination of triggering factors.
parafunctions: bruxism or horizontal sliding of the teeth leads to loss of incisal and occlusal relief and these changes are transmitted to the articular disc of which the activity would be affected.
continuous contraction of the lifting muscles, which may be reflex or caused by certain factors such as cold, are causes of joint pathologies.
trauma: direct and indirect blows lead to bone displacement or even fracture, with serious consequences for the transmission of mandibular movements.
general and dental disorders: arthritis, incorrectly adapted crown fillings, changes in dental position resulting from extractions which disrupt normal occlusal relations, with joint involvement.
Treatment of joint dysfunctions
The majority of disorders remit once the causes mentioned above are removed. Treatment with anti-inflammatory drugs is also useful.
Complex treatments are applied if ligaments and joint cartilages are damaged or we have contour deformities as a result of trauma.
However, prevention is the safest way to preserve the integrity of joint components.
This can be done by avoiding hard foods, relaxing the muscles and going to the dentist’s surgery where the doctor will identify factors that may disturb the normal activity of the temporomandibular joint.