Arthrosis is a serious disease that requires timely, comprehensive treatment. It develops in different joints of the body. Without proper treatment, the disease leads to disability. A similar disease can also appear in the temporomandibular joint (TMJ). This pathology has a number of symptoms, features. What is the disease, how is the treatment of arthrosis of the TMJ - all this is detailed in the article.
Features of the disease
TMJ arthrosis is a disease that develops in the area of the temporomandibular joint. Pathology is caused by dystrophic changes in the tissues of this area. This is a chronic disease that is accompanied by a number of unpleasant symptoms.
The temporomandibular joint is next to the ear. It connects the lower jaw to the skull. Movement in the joint allows you to move the jaw up and down and to the sides. This allows you to chew food, talk andetc. In the course of the development of arthrosis, thinning of the cartilaginous tissue occurs. It hurts to open and close your mouth. Gradually, the mobility of the joint decreases. This disease requires immediate treatment. Otherwise, the degenerative changes will be irreversible.
According to the international classification, arthrosis of the TMJ according to ICD-10 receives several codes. This category of diseases includes:
- M.19.0 - primary arthrosis in other joints.
- M.19.1 - post-traumatic arthrosis in other joints.
- M.19.2 - secondary disease of other joints.
- M.19.8 - other specified arthrosis.
If you do not take any action when signs of illness appear, pain will be determined in the nose. Hearing loss is also possible.
Previously it was believed that this disease is typical for the elderly. In the realities of the modern world, this is far from the case. This is due to a number of reasons. Young people also get injuries in the TMJ area. This leads to the gradual development of the disease. According to statistics, 50% of patients who are diagnosed with this disease are in the age group under 50 years. In the age group after 70 years, 90% of people suffer from arthrosis, which also develops in the TMJ area.
Reasons
TMJ arthrosis according to ICD-10 is a multifactorial disease. It can be caused by both local and general deviations in the functioning of the body. Often the main reason for the appearance of this disease is a genetic predisposition, infectious diseases. Also to the common factors that causepresented disease, include endocrinological diseases, vascular pathologies. One of the risk factors for developing osteoarthritis in women is menopause. At this time, the synthesis of sex hormones decreases. These substances are involved in the metabolism of bone and cartilage tissue. Therefore, a slowdown in metabolic processes can lead to adverse consequences.
Often, general and local factors in the development of the disease are combined. This significantly increases the risk of developing pathology. So, the cause of a local nature, which contributes to the development of the disease, is arthritis. Treatment for TMJ osteoarthritis often begins with inflammation. Arthritis causes joint problems. As a result, degenerative-dystrophic changes also develop in it. Therefore, treatment often begins with the suppression of the inflammatory process.
Other local causes that cause osteoarthritis may be malocclusion, partial dentition, tooth wear, bruxism, improperly placed fillings. Also, incorrect prosthetics often leads to the development of arthrosis of the jaw joint.
Injuries, blows in the TMJ area become a provoking factor in the development of the disease. In some cases, operations performed on this joint also lead to pathology.
The development of the disease is caused by excessive stress on the joint. Micro- and macrotraumas, inflammatory processes, neurodystrophic processes lead to changes in the force of impact on the tissues of the TMJ. Both joints (right and left) should work synchronously. Because ofof these factors, the load distribution changes, becomes inharmonious. This leads to dysfunction of the masticatory muscles. Cartilage tissue loses its elasticity. Because of this, there is a restructuring of bone tissue.
Classification
In the course of diagnosing arthritis and arthrosis of the TMJ, it is important to assess the degree of pathology development. Also, in order to choose the right method of treatment, the doctor must accurately determine what type of disease the disease belongs to. Arthrosis in the area of the lower jaw joint can be sclerosing and deforming. The first group of pathologies is characterized by severe sclerosis of bone tissue. At the same time, the joint spaces narrow.
With deforming arthrosis, an X-ray will show a flattening of the joint fossa, as well as its head and tubercle. Exophytes grow at the same time. If the stage of the disease is advanced, severe deformity of the joint head will be determined.
Considering the classification of arthrosis of the TMJ, it is worth noting that they are divided into two more groups. These are primary and secondary pathologies. In the first case, arthrosis occurs in old age without previous disease. It is caused by polyarticular lesions. Secondary arthrosis is a consequence of another disease. It could be inflammation, trauma, improper metabolism, etc.
The disease proceeds in four stages. At the initial stage, the narrowing in the joint is moderate, uneven. It defines instability. In the second stage, pronounced changes appear. Symptoms are extended.
The third stage is also calledlate. The functionality of the joint is limited. Cartilage completely degenerates. The articular surfaces are affected by massive sclerosis. Bone growths and flattening of the TMJ fossa are determined. The fourth (advanced) stage is characterized by complications such as the development of ankylosis of the fibrous type.
Symptomatics
There are certain symptoms of TMJ osteoarthritis. If you find even minor such manifestations, you should immediately consult a doctor. Arthrosis is a chronic disease. It develops slowly and gradually. As the disease progresses, symptoms will become more severe.
First, there is dysfunction in the muscles of the joint. Their work becomes uncoordinated, out of sync. Over time, this leads to displacement of the discs and head of the TMJ. They may even fall out.
In the early stages, symptoms may be almost invisible. In the course of the development of the disease, a pulling pain in the joint area is determined. It may radiate to the ear or nose. When you try to open your mouth, in the process of chewing, discomfort may intensify. You may hear a click or crunch when you do this.
Discomfort appears in the area of the joint. Sometimes there is a severe headache. The stiffness of the movement increases gradually. The joint can be deformed, displaced. The bite becomes irregular. Pain increases after exertion. If a person talked for a long time, chewed solid food, this can cause pulling, rather severe pain. They graduallysubside if the joint is at rest.
In rare cases, the disease provokes hearing loss. If arthrosis is left untreated, mobility in the TMJ will gradually decrease. Over time, a person will not be able to open his mouth, talk.
Diagnosis
If a person has the first signs of arthrosis of the TMJ, you need to urgently go to the hospital. Self-medication can be dangerous. Over time, this will lead to disability. The only way to solve the problem is through surgery. In order not to start the disease, you need to direct your efforts to curb degenerative changes.
To prescribe treatment, the doctor conducts a comprehensive diagnosis. It will be necessary to identify the root cause of the development of arthrosis. Otherwise, the treatment will be ineffective. The patient should contact an orthopedic dentist. He conducts an examination, palpation of the joint. Patient tells what symptoms he had and for how long.
The doctor determines the amplitude of movement of the muscles of the joint. He also orders x-rays. The picture will clearly show whether there are changes in the joint, as well as their severity. If the disease is at an early stage of development, this type of diagnosis, such as CT (computed tomography), can accurately establish this. However, this technique has a number of contraindications. It is contraindicated for children, pregnant and lactating women. As an additional examination, they may prescribe:
- arthrography;
- orthopantomography;
- electromyography;
- rheography;
- arthrophonography;
- gnathography;
- axiography.
In some cases, you need to get advice from other specialists. It can be an orthodontist, a rheumatologist, an endocrinologist, etc. The symptoms of arthrosis are similar to many other pathologies in the TMJ. Therefore, without a correct, comprehensive diagnosis, it is almost impossible to establish the cause of the disease.
Classic treatment
Treatment of arthrosis of the TMJ is carried out in accordance with the stage of the disease, as well as the reasons that caused it. The method of influence on the body should be complex. It includes medical treatment, physiotherapy. In some cases, orthopedic, and even surgical correction is required. The choice of the method of therapy depends on the characteristics of arthrosis.
In addition to the main treatment, recipes of traditional medicine are prescribed. Self-medication in this case is unacceptable. The doctor must develop a set of procedures and prescribe drugs. If you want to use traditional medicine, you need to consult your doctor.
Complex medical treatment aimed at relieving inflammation in the joint and its restoration is considered a classic. Two groups of drugs are prescribed:
- Anti-inflammatory nonsteroidal drugs. They can be taken orally or applied directly to the skin over the joint. The most popular drugs in this group are tablets and ointments based on diclofenac, ibuprofen, and paracetamol.
- Chondroprotectors. The composition of these drugs includes sulfatechondroitin, glucosamine.
Means are prescribed by the doctor individually. It takes into account the characteristics of the patient's body. It is also necessary to eliminate the factor provoking the disease.
Correctors
Considering the features of treatment and symptoms of arthrosis of the TMJ, it is worth noting the insufficient effect of medications on the affected joint. Often, in combination with classical methods, the doctor prescribes the wearing of special devices. These are orthopedic correctors. They allow you to coordinate the work of the muscles of the joint. The jaws in this case begin to move along the correct trajectory. Overbite corrected.
Proofreaders can be removable and non-removable. The choice of such devices depends on the severity of the disease.
Other methods
Sometimes it happens that sclerosing or deforming arthrosis of the TMJ is detected already at an advanced stage. In this case, the disease is not amenable to conservative treatment. Surgery is indicated. There are three types of such influence:
- Removal of the head of the joint.
- Replacing the head with a prosthesis.
- Removal of the articular disc.
After the operation, the patient must undergo a course of rehabilitation. This avoids the development of complications. The healing process is faster. Rehabilitation methods include exposure to ultrasound, electrophoresis, UHF, exercise therapy.
Traditional medicine
During the treatment of arthrosis of the TMJ, you can use traditional medicine recipes. They are not practiced as a standalone remedy.therapy. Folk recipes can complement conservative methods.
A popular recipe is elecampane tincture. It is rubbed into the skin over the affected joint. It is necessary to pour 50 g of elecampane root 0.3 liters of vodka. The composition is insisted for 12 days. The container must be made of dark glass. Every day the tincture is shaken. The composition is filtered and used at bedtime. After the procedure, the joint area is wrapped with a woolen scarf.
An effective remedy is a compress with honey (15 ml) and apple cider vinegar (3 tablespoons). The composition is applied to the surface of the joint. She is covered with a cabbage leaf and covered with polyethylene. Also, the joint is wrapped with a warm scarf.
Forecast and prevention
If arthrosis of the TMJ is detected in the early stages, the success of conservative treatment will be high. If the disease is in an advanced stage, an operation is performed. The recovery period will be long. To prevent the development of such a pathology, it is necessary not to overload the joint. You should also visit the dentist regularly (once a year), monitor oral hygiene.
Having considered the features and varieties of TMJ arthrosis, causes and symptoms, as well as treatment methods, one can understand the importance of timely detection of pathology. The success of therapy, its duration depends on this.
