TREATMENT OF TEMPOROMANDIBULAR DYSFUNCTIONS - TMJS
Oftentimes dental patients refer symptoms such as pain upon closing or opening the jaw, or inability to bite confidently etc.
As extrapolated by large-scale studies, a significant prevalence of signs related to dysfunctions of Temporomandibular Joints and/or muscluture, is typically addressed among the generic population. Due to sub-clinical or cyclic occurrence of symptoms, very few patients however are becoming aware of their syndrome so as to seek suitable therapy.
- facial pain or headache pain during mastication, speech
- pain on the face/TMJs/teeth, triggered by eterotopic areas on the cerebral column and or the central nervous system
- facial or headache pain at the preauricular site strongly mimicking earache pain
- TMJ sounds induced during the movement of the jaw
- Reduced opening or lateral deviation of the jaw upon opening
On occasion more complex signs occur, which can be misleading. Such can be toothaches, automatic stimulation of lacrimal glands (tears on one eye), discharge from the nose (single nostril) etc.
- Trauma on the face, jaw or the cervix
- Bruxism (clenching or grinding of the teeth)
- New prosthetic restoration
- History of Inflammatory diseases ie arthritis
- Neuralgias originated in the central nervous system
- Psychological traits
- Predisposition due to specific anatomic/morphological features of the TMJs
Symptomatic_ Immediate relief from the symptoms is aimed in the very early phase. Treatment modalities are usually reversible-type in this early stage. Occlusal appliances (mouth guards) and/or selective grinding on centric relation are treatments of choice to accomodate dysfunctions of masticatory muscles or the TMJs. Specific methodology is employed to properly diagnose origin of pain - TMJs or masticatory muscles. Improper diagnosis leads to failed therapy. Hence, exacerbation of pain and metamorhosis on to chronic-type may terminally occur. As proper symptomatic treatment is started, pain typically recedes quite immediately. That improvement is a prerequisite as to proceed to the definitive therapy.
Etiologic_ Non-reversible-type therapeutic modalities aim to replicate the orthopedic stability as achieved with the mouth-guards to the natural dentition. Non-invasive bonded onlays and 360 veneers are mainly employed to fully reconstruct occlusion thus helping shift the mandible to a well-rested and asymptomatic position. Moreover orthodontic appliances are bonded to posterior teeth to optimize occlusal contacts and reassume orthopedic stability.