Temporomandibular Joint Problems (TMJ)

 

The temporomandibular joint (TMJ) or jaw joint allows a wide range of movements of the lower jaw.

It is a complex structure but still must be considered as a joint of the body.

Hence it can suffer the same problems as the other joints including injury, osteoarthritis, inflammatory arthritis (Rheumatoid arthritis, psoriatic arthritis) and rarely cancer.

Collapse of the TMJ may also be seen resulting in a jaw or bite deformity with backward movement of the chin if the problem is on both sides or shifting of the chin to the involved side if it involves one joint. Once the TMJ is significantly involved, difficulty in opening the jaw (closed lock ) or pain or both may be experienced when placing the jaw under function.

The possibility of the jaw muscles causing the pain and restriction must be excluded prior to any treatment on the TMJ.

This may be in the form of physiotherapy and also a dental or occlusal splint. Appropriate Xrays and often a MRI of the TMJ region is required to confirm the diagnosis.

If the problem persists, a decision is made regarding ongoing treatment. This may involve non-surgical or surgical management.

The surgical management may include procedures similar to that used on the knee including arthroscopy ( key hole surgery), open surgery (arthroplasty) and in the end stage degenerative cases or tumours, a total joint replacement would be appropriate. These joint replacements are custom-made for the patient and get an excellent outcome.