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 occur in the temporomandibular joint (TMJ). This pathology has a number of symptoms, features. What is the disease, how is the treatment of TMJ arthrosis carried out - about all this in detail in the article.
Features of the disease
TMJ arthrosis is a disease that develops in the temporomandibular joint. Pathology is due to 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 located next to the ear. It connects the lower jaw to the skull. Movement in the joint allows the jaw to move up and down and to the sides. This allows you to chew food, talk, etc. During the development of arthrosis, cartilage tissue becomes thinner. Opening and closing your mouth becomes painful. Gradually, joint mobility decreases. This disease requires immediate treatment. Otherwise, degenerative changes will be irreversible.
According to the international classification, TMJ arthrosis 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 - a secondary disease of other joints.
- M.19.8 - another specified arthrosis.
If you do not take any action when signs of illness appear, pain will be determined in the nose. Hearing impairment is also possible.
Previously it was believed that this ailment is characteristic of the elderly. In the realities of the modern world, this is far from the case. There are several reasons for this. Young people are also injured in the TMJ. This leads to the gradual development of the disease. According to statistics, 50% of patients who are diagnosed with this 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.
Causes
ICJ-10 TMJ arthrosis is a multifactorial disease. It can cause both local and general deviations in the body. Often the main cause of this disease becomes a genetic predisposition, infectious diseases. Also, common factors that cause the presented disease include endocrinological diseases, vascular pathologies. One of the risk factors for developing arthrosis in women is the period of menopause. At this time, the synthesis of sex hormones is reduced. These substances are involved in the metabolism of bone, cartilage. Therefore, a slowdown in metabolic processes can lead to adverse consequences.
Often, general and local factors for the development of the disease are combined. This significantly increases the risk of developing pathology. So, the cause of the local nature, which contributes to the development of the disease, is arthritis. Treatment for TMJ arthrosis often begins with the elimination of inflammation. Arthritis causes disturbances in the joint. As a result, degenerative-dystrophic changes develop in it . Therefore, often treatment begins with the suppression of the inflammatory process.
Other local causes that cause arthrosis may include malocclusion, partial adentia, tooth abrasion, bruxism, and improper fillings. Also, incorrect prosthetics often leads to the development of arthrosis of the jaw joint.
Injuries, strokes 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 the appearance of pathology.
The development of the disease is caused by excessive stress on the joint. Micro- and macro-traumas, inflammatory processes, neurodystrophic processes lead to changes in the force of exposure to TMJ tissues. Both joints (left and right) should work synchronously. Due to these factors, the load distribution changes, it becomes inharmonious. This leads to masticatory muscle dysfunction. Cartilage tissue loses its elasticity. Because of this, rearrangement of bone tissue occurs.
Classification
During the diagnosis of arthritis and arthrosis of TMJ, it is important to assess the degree of development of pathology. Also, to choose the right treatment method, the doctor must determine exactly what type of disease the disease belongs to. Arthrosis in the joint area of the lower jaw can be sclerosing and deforming. The first group of pathologies is characterized by severe sclerosis of bone tissue. At the same time, the joint gaps narrow.
With deforming arthrosis on the x-ray, a flattening of the fossa of the joint, as well as its head and tubercle will be visible. Exophytes grow in this case. If the stage of the disease is advanced, severe deformation of the head of the joint will be determined.
Considering the classification of TMJ arthrosis, 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 a previous disease. It is caused by polyarticular lesions. Secondary arthrosis is a consequence of another disease. This can be inflammation, trauma, improper metabolism, etc.
The disease proceeds in four stages. At the initial stage, the narrowing of the joint is moderate, uneven. It defines instability. In the second stage, pronounced changes appear. Symptoms are detailed.
The third stage is also called late. The functionality of the joint is limited. Cartilage tissue completely degenerates. Joint surfaces are affected by massive sclerosis. Bone growths and flattening of the TMJ fossa are determined. The fourth (neglected) stage is characterized by such complications as the development of fibrous type ankylosis.
Symptomatology
There are certain symptoms of TMJ arthrosis. If even such minor manifestations are detected, you should immediately consult a doctor. Arthrosis is a chronic disease. It develops slowly and gradually. As the disease progresses, symptoms will become more pronounced.
First, dysfunction appears in the muscles of the joint. Their work becomes uncoordinated, unsynchronous. Over time, this leads to displacement of the discs and head of the TMJ. They may even fall out.
In the early stages, symptoms can be almost invisible. During the development of the disease, drawing pain in the joint area is determined. It can radiate to the ear or nose. When you try to open your mouth, during chewing, discomfort may intensify. You can hear a clicking or crunching sound.
Discomfort appears in the joint area. Sometimes a severe headache appears. The stiffness of the movement increases gradually. The joint can be deformed, displaced. The bite becomes wrong. Soreness rises after exertion. If a person has been talking for a long time, chewing solid food, this can cause pulling, rather severe pains. They gradually subside if the joint is at rest.
In rare cases, the disease provokes hearing loss. If untreated arthrosis, mobility in the TMJ will gradually decrease. Over time, a person will not be able to open his mouth, talk.
Diagnostics
If a person has the first signs of TMJ arthrosis, an urgent need to go to the hospital. Self-medication can be dangerous. Over time, this will lead to disability. It will be possible to solve the problem only surgically. In order not to start the disease, you need to focus on restraining 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 consult an orthopedic dentist. He conducts examination, palpation of the joint. The patient tells what symptoms he had and how long.
The doctor determines the amplitude of movement of the muscles of the joint. Also appoints an x-ray examination. 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, a type of diagnosis such as CT (computed tomography) can establish this accurately. However, this technique has a number of contraindications. For children, pregnant and lactating women, it is contraindicated. As an additional examination, you can prescribe:
- arthrography;
- orthopantomography;
- electromyography;
- rheography;
- arthrophonography;
- gnatography;
- axiography.
In some cases, consultation with other specialists is required. This may be an orthodontist, rheumatologist, endocrinologist, etc. Symptoms of arthrosis are similar to many other pathologies in the TMJ. Therefore, without the correct, comprehensive diagnosis, it is almost impossible to establish the cause of the ailment.
Classic treatment
Treatment of TMJ arthrosis is carried out in accordance with the stage of the disease, as well as the causes that caused it. The method of exposure to the body should be comprehensive. It includes drug treatment, physiotherapy. In some cases, orthopedic, and even surgical correction is required. The choice of method of therapy depends on the characteristics of arthrosis.
In addition to the main treatment, traditional medicine recipes are prescribed. Self-medication in this case is unacceptable. The doctor should develop a set of procedures and prescribe drugs. If you want to use traditional medicine, you need to consult your doctor.
Medication is considered a complex drug treatment aimed at relieving inflammation in the joint and its recovery. Prescribe drugs in two groups:
- Anti-inflammatory non-steroidal drugs. They can be used both orally and applied directly to the skin above the joint. The most popular drugs in this group are tablets and ointments based on diclofenac, ibuprofen, as well as paracetamol.
- Chondroprotectors. The composition of these drugs includes chondroitin sulfate, glucosamine.
The funds 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.
Proofreaders
Considering the treatment features and symptoms of TMJ arthrosis, it is worth noting the inadequate effect of medications on the affected joint. Often in conjunction with classical techniques, the doctor prescribes the wearing of special devices. These are orthopedic proofreaders. They allow you to coordinate the work of the muscles of the joint. The jaws in this case begin to move along the correct path. The bite is corrected.
Proofreaders can be removable and non-removable. The choice of such devices depends on the severity of the disease.
Other techniques
Sometimes it happens that sclerosing or deforming arthrosis of the TMJ is detected already in an advanced stage. In this case, the disease is not amenable to conservative treatment. Surgical intervention is indicated. There are three types of such effects:
- 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 rehabilitation course. This avoids the development of complications. The healing process is faster. Rehabilitation methods include exposure to ultrasound, electrophoresis, UHF, exercise therapy.
ethnoscience
During the treatment of TMJ arthrosis, you can use traditional medicine recipes. They are not practiced as a separate therapy. Folk recipes can complement conservative techniques.
A popular recipe is tincture of elecampane. It is rubbed into the skin over the affected joint. It is necessary to fill in 50 g of the root of elecampane 0.3 liters of vodka. The composition is insisted for 12 days. The container should be made of dark glass. Every day, the tincture is shaken. The composition is filtered and applied before bedtime. After the procedure, the joint area is wrapped in a woolen scarf.
An effective remedy is a compress with honey (15 ml) and apple cider vinegar (3 tbsp. Tablespoons). The composition is applied to the surface of the joint. She is covered with a leaf of cabbage and covered with polyethylene. Also, the joint is wrapped in a warm scarf.
Forecast and Prevention
If TMJ arthrosis 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. In order to prevent the development of such a pathology, you need not to overload the joint. You should also regularly visit the dentist (once a year), monitor oral hygiene.
Having examined the features and varieties of TMJ arthrosis, causes and symptoms, as well as treatment methods, we can understand the importance of timely detection of pathology. The success of therapy, its duration, depends on this.