Arthritis of the temporomandibular joint is formed as a result of the inflammatory process. This is a fairly rare disease. Therefore, doctors with experience who treat this disease are rarely found.
The disease occurs as a result of loss of water in the articular cartilage. This makes it inelastic, the fibers gradually break down, the cartilage becomes rough and covered with cracks. Instead of the usual sliding that occurs when opening the mouth, friction is formed.
The disease occurs in humans for various reasons.
The most common include:
Most often, arthritis of the maxillofacial joint develops by the age of 40-45. If an incomprehensible crunch occurs in the jaw, dull pain and movements become limited, you should immediately visit a doctor.
The symptoms of this disease differ from other types, and a specialist will help determine the cause of their manifestations.
“primary arthritis” made by conducting a laboratory examination. It is determined after receiving test results.
The secondary type occurs after injuries or dysfunction of the human vascular system. Manifestations of maxillofacial disease can occur not only in adulthood. They are also possible in small children.
The nature of the manifestation of symptoms of the disease divides arthritis into types:
The disease is manifested by swelling of the soft tissues, the occurrence of severe and sharp pain, which occurs when the jaw joint is damaged.
In such cases, the pain increases when chewing and can radiate to the back of the head or ear.
Acute infectious arthritis
It occurs in humans as complications after infectious diseases. Symptoms are manifested by very severe pain, which limits movement when opening the mouth and radiates to the back of the head, temple and ear. When pressing on the cartilage in the ear area, it intensifies, as with otitis media.
It occurs as a result of complications of an advanced acute type of disease. Symptoms are expressed by the formation of compactions in the area of the temporomandibular joint. Redness appears on the skin in the area of inflammation.
The patient experiences severe pain and dizziness. The inflammatory process provokes an increase in body temperature.
Symptoms of the disease are determined by sharp pain in the maxillofacial joint. The rheumatoid type of the disease is often accompanied by severe pain not only in the jaw area, but throughout the body.
With this disease, inflammation of the knee joint and arm shoulder can occur.
Symptoms are characterized by aching pain in the temporomandibular joint. After sleep, the patient experiences stiffness when moving the jaw. When talking or chewing, a sharp pain occurs, which is accompanied by an unpleasant crunching sound.
Specific infectious arthritis
This is a fairly rare disease that manifests itself as a result of tuberculosis, syphilis or gonorrhea. The infection enters the jaw joint by entering through the lymph nodes or blood vessels. Symptoms of the disease include pain in the temporomandibular joint and fever. The pain intensifies when opening the mouth and chewing movements.
If symptoms of jaw joint disease occur, you should definitely consult a doctor. A specialist will be able to determine the cause of the disease and select the correct treatment. If necessary, a diagnostic examination will be performed.
Ordinary arthritis of the maxillofacial cartilage is an inflammatory disease, and self-medication is not recommended. It is imperative to consult a doctor, because different types require special treatment.
Depending on the patient’s condition, the doctor prescribes medications that have anti-inflammatory properties, analgesics or hormonal agents. Treatment depends on the degree of disease and inflammation of the maxillofacial joint.
Taking into account the patient’s condition, the doctor prescribes comprehensive treatment including therapeutic exercises, massage and other procedures. Sometimes, after consultation with a doctor, traditional medicine is used. They may have a preventive or auxiliary effect. In case of a very advanced or severe form of the disease, surgical intervention is possible.
In addition to the use of medications and traditional medicine methods, it is recommended to lead a healthy lifestyle. Proper nutrition, adherence to a daily routine and exercise will help improve the health of the body and avoid the occurrence of various diseases.
In practice, damage to the temporomandibular joint (TMJ) by arthritis is quite rare. This is why there are so few specialists with positive experience in treating this rare disease. Arthritis, in essence, is an inflammatory process, and the cause of damage to the paired joints of the skull can be infections or injuries.
Depending on the root cause of the disease, there are two types of arthritis:
They can take an acute or chronic course. Various types of rheumatic processes can also lead to arthritis of the maxillofacial joint:
In addition, arthritis, characterized by an infectious nature, is divided into two categories:
For any form of arthritis, treatment of the disease requires an integrated approach. The general treatment regimen includes:
The occurrence of acute arthritis of the TMJ of traumatic etiology is provoked by various types of mechanical influences. The problem can be caused by a blow, bruise, or opening the mouth too much. In this case, victims complain of symptoms such as pain in the maxillofacial joint that occurs when opening the mouth. In addition, the movement of the jaw in the vertical plane causes the chin to shift towards the diseased joint.
There is swelling in the joint area, and its palpation is accompanied by severe pain. If the mechanical impact did not fracture the bone structures of the condylar process, then radiography does not reveal any abnormalities in the patient. And only with ruptures of the ligamentous apparatus, causing hemorrhage in the articular area, the radiograph shows an abnormal expansion of the joint space.
Typically, the development of acute arthritis provoked by infectious diseases occurs against the background of influenza, colds, tonsillitis, etc. Arthritis of a rheumatic and rheumatoid nature is caused by hematogenous infection or the spread of infection during otitis, mastoiditis, purulent mumps, osteomyelitis of the jaw branch, etc.
The disease begins with sharp joint pain, especially intensifying when moving the jaw. Emerging pain often radiates to different areas: tongue, ear, temple or back of the head. The pain passes in the directions of the auriculotemporal, lesser occipital, greater auricular nerves, as well as along the auricular branch of the vagus nerve connected to the glossopharyngeal nerve.
The main distinctive features of pain, which make it possible not to confuse acute arthritis with trigeminal neuralgia, are localized and pulsating in nature.
In addition, there is a limitation in the motor ability of the jaws - the mouth can be opened by a maximum of 3-5 mm. Examination of the patient reveals obvious swelling of the soft tissues in the area located in front of the tragus of the ear. Palpation is painful, and hyperemia of the skin is obvious.
Acute arthritis can transform into a purulent phase. With purulent arthritis, the following symptoms are observed:
Increased pain is especially noticeable when pressing upward and forward on the chin area. The x-ray shows widening of the joint space.
Rheumatoid arthritis can be accompanied by bilateral damage to the joints, and examination of the patient is usually accompanied by the detection of heart diseases - heart disease, rheumatic carditis, etc.
Rheumatoid arthritis usually affects only one TMJ joint, but patients experience pain that radiates to the shoulder, knee, or hip joint. In rheumatoid arthritis, the TMJ is usually affected after other joints are affected. The disease is not accompanied by visible cardiac pathologies, and the pain is not characterized by volatility.
Accurate diagnosis of acute arthritis is complicated by the similarity of its symptoms with trigeminal neuralgia, otitis media, pericoronitis and other diseases, the clinical picture of which is accompanied by severe arthropathy.
For any etiology, providing rest to the diseased joint is of paramount importance. For this purpose, a sling-shaped bandage is made, used together with a plate (gasket) applied for several days. Only liquid food is used to feed the patient.
The goal of treating traumatic arthritis of the maxillofacial joint is, first of all, to relieve pain and reabsorb the blood that has spilled into the joint area.
The fight against rheumatoid and rheumatoid arthritis is carried out mainly with the help of conservative means under the constant supervision of a rheumatologist. Therapy includes steroidal and non-steroidal anti-inflammatory drugs, antibacterial agents.
The administration of drugs requires special caution - it is prohibited to inject more than one ml of solution into the joint at a time. Neglecting this rule can lead to pathological stretching of the joint capsule. The dentist’s task includes sanitation of the oral cavity, as well as the selection of dentures to ensure a normal bite height.
Purulent arthritis is especially dangerous - it requires urgent surgical intervention. Naturally, the operation to open and drain the inflamed lesion is carried out in a hospital. After surgery, conservative treatment is indicated, including UHF therapy, compresses, electrophoresis, diathermy and simply dry heat.
Completeness and timeliness of treatment is the guarantee that acute arthritis, traumatic or purulent, will not be complicated by ankylosis. If treatment of acute rheumatic or rheumatoid arthritis is neglected, the disease can transform into a chronic form.
The chronic course of the disease is accompanied by the following pronounced symptoms in the joints:
The pain can be constant, spontaneous, or intensifying when trying to resume movement of the lower jaw. Opening of the mouth (no more than 2-2.5 mm) is accompanied by a crunching sound and a shift of the chin to the affected side. Palpation is clearly painful, but the skin may not have visible changes. The radiograph reveals a clear narrowing of the joint space due to destructive processes in the integumentary cartilage.
Chronic arthritis of the TMJ occurs against the background of a satisfactory condition of the patient. The temperature is normal, the blood is without any changes, but the ESR increases to 25-35 mm/h. In case of exacerbation, the disease can suddenly develop into the form of acute inflammation.
Rheumatologists treat rheumatic and rheumatoid forms of chronic arthritis of the maxillofacial joint. Traumatic arthritis can also transform into a chronic form. Treatment includes the following therapeutic measures:
Complex treatment should be accompanied by thorough sanitation of the nasopharynx and oral cavity. If indicated, dental prosthetics are performed.
If rheumatoid arthritis is sometimes accompanied by irreversible consequences, then with proper treatment of rheumatoid arthritis it is possible to completely restore the functionality of the joint and eliminate pathological changes.
Infection-specific forms of TMJ arthritis are quite rare, among them it is worth noting:
The cause of the above forms of infection-specific arthritis is the spread of infection through the hematogenous route. When fighting such forms of arthritis, medicine focuses on eliminating the primary disease, which is carried out by doctors of the appropriate profile.
The mobility of the human lower jaw is ensured by a combined joint that connects it to the skull, with the temporomandibular joint (abbreviated TMJ). Like any other joint, it is susceptible to various diseases, caused by infections or injuries. One such disease may be arthritis of the jaw joint. The disease is an inflammation of cartilage tissue. Incorrect and untimely treatment of arthritis threatens the development of complete immobility of the joint.
Elderly people are at risk, especially those who already have bone lesions from rheumatoid arthritis, but the disease can also affect a fairly young age group (even children). The cause of the inflammatory process in the joint can also be severe hypothermia.
Depending on the triggering source, arthritis of the jaw can be divided into three main types:
Symptoms appear depending on the causes of inflammation.
Traumatic arthritis of the maxillofacial joint is manifested by pain not only during movement of the joint, but also in its static position. Characteristic features are:
As a result of the injury, ligamentous ruptures may occur; in this case, x-rays will record foci of hemorrhage.
At the initial stage of development, arthritis of the jaw joint causes the following symptoms:
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Rheumatoid arthritis of the TMJ, which is a consequence of existing diseases, is often bilateral, often develops against the background of cardiac pathologies, and rheumatoid arthritis usually affects one joint and is not associated with the cardiovascular system.
Untimely treatment of these types of arthritis leads to their development into chronic forms with the following symptoms:
Infectious arthritis of the temporomandibular joint is usually acute (suppuration is possible).
Failure to provide qualified assistance or improper treatment will lead to the outpouring of purulent contents and contamination of surrounding tissues, which will lead to complications including disability.
Treatment of arthritis of the maxillofacial joint consists of first eliminating pain symptoms, and then carrying out therapy to stop the destructive process.
The joint must be provided with complete rest. To do this, a pressure bandage with a spacer between the teeth can be applied.
Treatment of traumatic arthritis consists of a doctor prescribing analgesics and anti-inflammatory drugs to relieve pain, swelling and inflammation for a course of about a week. When jaw function is restored, the following procedures begin:
All of the above manipulations effectively treat arthritis of the temporomandibular joint, provided that they are performed regularly and alternately for a week until the symptoms disappear completely. The same methods can be used to treat chronic arthritis.
Rheumatoid facial arthritis requires the use of non-steroidal anti-inflammatory drugs (Ibuprofen, Aspirin, Diclofenac). Particular attention is paid to the sanitation of the oral cavity.
The following methods are used:
Untimely treatment of this type of articular arthritis will lead to damage to adjacent tissues and complete immobility of the jaw - ankylosis.
A very dangerous disease due to the proximity of the lesion to the brain. Spread of infection can be fatal. Treatment of infectious arthritis consists of quickly eliminating the source of infection using broad-spectrum antibiotics (penicillins) and salicylates (vitamin C-based drugs). Among physical procedures, mercury-quartz irradiation is effective.
First of all, it should be noted that you should not heat the sore spot and use irritating ointments like Finalgon. Purulent arthritis of the temporomandibular joint requires opening the source of suppuration, its complete sanitation and drainage. After which antibiotics are prescribed to relieve inflammation and prevent the spread of infection, anti-inflammatory and hormonal agents. During the recovery period, UHF therapy, electrophoresis, and absorbable compresses are performed.
Drug treatment of arthritis of the maxillofacial joint can be supplemented with various folk recipes.
Infusions from:
A decoction is prepared from a mixture of herbs in equal proportions: boil 3 tablespoons per 0.5 liter of water over low heat for 20 minutes, leave for an hour. Take 4 tablespoons three times a day.
Traditional recipes can only be used as concomitant drugs in the treatment of the disease or maintenance therapy during its stable remission.
To prevent the symptoms of jaw arthritis from returning, as well as for the purpose of prevention, a number of conditions should be observed:
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Arthritis of the temporomandibular joint (TMJ) is an acute or chronic inflammation of the structural elements of the joint, which is accompanied by pain and disruption of its function.
According to statistics, young and middle-aged people are more likely to encounter this problem.
Taking into account the cause and clinical features of the disease, the pathology can be treated by a traumatologist, dentist, ENT specialist or rheumatologist.
The maxillary joint is a paired formation that allows the lower jaw to move in different directions.
It is formed by the articular head of the lower jaw and the cavity of the temporal bone, as well as the capsule, muscles and ligaments that hold the joint in the desired position.
The joint is combined, it consists of separate right and left blocks. Both temporomandibular joints perform movements simultaneously, working as a single joint.
Unique intra-articular cartilage allows the joint to move in three directions, allowing for chewing movements, opening and closing of the mouth, and forward and backward movement of the jaw.
The blood supply to the joint comes from the external carotid artery. It is innervated by the branches of the trigeminal nerve, which explains the spread of pain in TMJ arthritis to the ear, cheek, neck and teeth.
Arthritis of the temporomandibular joint is its inflammation (infectious or non-infectious), which occurs in acute or chronic form.
The inflammatory process can involve all elements of the joint or be limited to the capsule and periarticular tissues.
Taking into account the cause that triggered the inflammatory reaction, infectious and non-infectious arthritis of the maxillofacial joint is distinguished.
Infectious can be:
Non-infectious arthritis is traumatic, rheumatoid and reactive.
The acute stage of arthritis includes periods of serous and purulent inflammation of the joint.
If the cause of the disease is an infection, it can enter the joint hematogenously (through blood), contact (inflammatory process of nearby structures) or through fractures and injuries of the temporomandibular joint.
Specific infectious arthritis is more often transmitted through blood during syphilis, tuberculosis, chlamydia and some other diseases.
Nonspecific microflora enters the joint in the presence of an inflammatory process in nearby tissues, for example, with purulent otitis media, boils of the external auditory canal, inflammation of the salivary and parotid glands, mastoiditis, etc.
Gunshot wounds, trauma, open wounds, and fractures in this area can cause arthritis. Failure to comply with the rules of asepsis during surgery on the temporomandibular joint can also trigger an inflammatory reaction.
The causes of non-infectious arthritis are:
Clinical symptoms of TMJ arthritis depend on the cause of the disease, the stage of the inflammatory process and the individual characteristics of the patient.
The most common is ordinary acute nonspecific arthritis, which is characterized by the following symptoms:
With severe swelling, patients may complain of decreased hearing due to narrowing of the external auditory canal. With purulent joint abscesses, they can independently break into the external auditory canal (suppuration is observed from the ear) or into the parotid tissue.
The chronic stage is characterized by less pronounced symptoms:
Long-term chronic inflammation leads to joint deformation and the development of contractures (restriction of movement in the joint).
The main clinical symptoms of rheumatoid arthritis of the temporomandibular joint:
Traumatic arthritis is accompanied by severe pain at the time of injury, followed by limitation of joint function and hemorrhages.
The prognosis and symptoms depend on the degree and nature of joint damage (rupture of ligaments, muscles, nerve fibers and blood vessels).
The clinic of specific infectious arthritis is determined by the properties of the pathogen:
Find out how to distinguish TMJ arthritis from arthrosis.
Diagnosis of the disease is carried out by various specialists, taking into account the suspected cause of the problem. This could be a traumatologist, surgeon, therapist, rheumatologist, dentist and others.
The main method of diagnosis is x-ray or CT scan of the temporomandibular joint.
Signs of acute inflammation are expansion of the joint space; in chronic forms, the degree of narrowing in mm is assessed.
When diagnosing rheumatoid arthritis, blood test data (increased ESR, rheumatoid factor) and a combination of other signs (multiple lesions of small joints, the appearance of rheumatoid nodules, enlarged lymph nodes, etc.) are considered.
Diagnosis of specific arthritis is based on PCR (polymerase chain reaction) and enzyme immunoassays.
Treatment of any type of arthritis of the temporomandibular joint begins with immobilizing it using special bandages or plates for several days.
For acute infectious arthritis, the following medications are indicated:
The purulent process in the joint requires surgical intervention and drainage of the pus.
During the recovery stages, various types of physiotherapy are used (magnetic laser therapy, paraffin therapy, electrowave therapy, etc.).
Rheumatoid arthritis is treated with non-steroidal anti-inflammatory drugs, hormones, cytostatics and antirheumatic drugs.
Treatment of specific forms of the disease is carried out with antibiotics, taking into account the sensitivity of the pathogen.
Chronic forms of the disease are observed and treated with physiotherapy, therapeutic exercises and special massage.
They attach importance to the elimination of dental pathology and the treatment of chronic infections of the oropharynx (tonsillitis, pharyngitis, etc.).
Treatment with traditional medicine is carried out in combination with traditional drug therapy for TMJ arthritis.
Use homemade warming compresses, ointments and tinctures:
The outcome of acute arthritis is favorable and ends with complete restoration of joint function.
Chronic processes often lead to the formation of ankylosis and contractures, which impair the functionality of the lower jaw and cause many problems for the patient. They can only be solved surgically.
Preventive measures include treatment of specific infections, prevention of bruises and joint injuries and timely treatment of chronic foci of infection.
Arthritis of the maxillofacial joint is a serious problem that requires specialist consultation and drug treatment.
To prevent illness, you should be attentive to your health, eliminate specific infections and avoid injury to the joint.
Depending on the etiology of damage to the temporomandibular joint, there are:
Arthritis of the temporomandibular joint, according to the nature of its course, can be:
It occurs as a result of intense mechanical damage: bruise, blow, excessive opening of the mouth and others, especially if the injury is combined with hemorrhage into the joint cavity.
Occurs against the background of an infectious disease: exacerbation of chronic tonsillitis, acute respiratory viral infection, otitis, phlegmon, mastoiditis, mumps, measles, scarlet fever, osteomyelitis of the upper jaw and others. The spread of infection occurs through hematogenous means, as a rule, its source is located near the joint.
In severe cases, an infiltrate forms in the area of the affected joint, which then undergoes purulent melting. The formation of purulent arthritis is accompanied by high fever (38° and above), hyperesthesia, hyperemia and tension of the skin over the area of infiltration (the skin does not fold), narrowing of the ear canal, hearing impairment, and dizziness. The pain intensifies when pressing forward on the chin. Characterized by pronounced “inflammatory” changes in laboratory tests: acceleration of ESR, increase in C-reactive protein.
It rarely affects the temporomandibular joint, and if this happens, usually other joints are initially involved in the lesion - knee, hip, shoulder. The lesion is usually bilateral.
Currently rare. The most common of them are: tuberculosis, gonorrheal, syphilitic, actinomycotic and others. Their pathogenesis is associated with hematogenous or lymphogenous spread of infection. Treatment is aimed at relieving the symptoms of the underlying disease.
There are three forms: primary synovial, primary bone, infectious-allergic. It develops gradually and is characterized by a long course with the formation of fibrous ankylosis. The X-ray shows destruction of the head of the mandible.
It proceeds sluggishly, almost painlessly. Rarely seen.
Usually occurs acutely in the first month of the disease, with severe signs of pain, swelling, narrowing of the ear canal and hearing loss. The process quickly transforms into a purulent form, and an infiltrate is formed. Muscle contracture occurs early, articular cartilage is affected and ankylosis occurs. Based on the results of radiography, a narrowing of the joint space is determined.
The patient's health usually does not suffer. Moderate pain in the joint may occur, worsening when opening the mouth. The process occurs with periods of remission; as a result, an unstable contracture may form. After treatment, there are no changes in the joint.
Symptoms of chronic arthritis of the temporomandibular joint are:
Based on the results, X-rays of the temporomandibular joint can reveal: narrowing of the joint space, destructive changes in the articular cartilage and articular fossa.
The patient’s health may not suffer, the temperature is normal or subfebrile, and there may be an acceleration of ESR in the blood.
Chronic arthritis can worsen, acquiring acute features during exacerbations.
As the disease progresses, it can lead to destruction and shortening of the head of the lower jaw (especially at a young age), resulting in malocclusion. Ankylosis may form.
Acute arthritis of the temporomandibular joint is primarily differentiated from trigeminal neuritis, pericoronitis and other dental pathologies, otitis, mastoiditis and other diseases.
Common to all types of arthritis of the temporomandibular joint is: ensuring “rest” of the affected joint for 2-3 days, which is achieved by applying a special sling-shaped bandage and an interdental plate or spacer. During this time, the patient can only eat liquid food.
If necessary, sanitation of the oral cavity (mandatory for infectious and rheumatoid arthritis) and bite correction are carried out in parallel.
Further treatment depends on the etiology of the arthritis.
In acute purulent and traumatic arthritis - favorable, but in the case of untimely treatment, ankylosis may form (especially in childhood). Reactive arthritis can transform into rheumatoid arthritis, which in turn is prone to chronicity. The changes that occur in the joint during reactive arthritis are reversible, unlike rheumatoid arthritis.