Articulaciones temporo-mandibulares: trastornos y tratamientos

Written by: Dott. Gaetano Calesini
Edited by: Antonietta Rizzotti

Temporo-mandibular joints: disorders and treatments

The temporomandibular joints (ATM) allow us to open and close the mouth, swallow and talk. Their dysfunction can lead to a series of unpleasant disturbances. Dr. Gaetano Calesini, an expert in dentistry in Rome, talks about it

What is ATM?
The temporomandibular joint articulates the mandibular bone with the cranial base; in particular it connects the mandibular condyle with the temporal glenoid fossa. Between the two bony heads there is interposed a disc of fibrocartilage that connects the bone structures and moves along with the condyle. The joint, contained in a joint capsule, is covered inside by a membrane called a synovium. The synovium produces the synovial fluid that lubricates the articular heads, allowing them to function correctly.

How does the ATM work?
The temporomandibular joint is one of the most complex joints of the human body, and joins the mandible at the base of the skull. It is a double joint whose correct functioning allows to open and close the mouth, to swallow and to speak, making a complex movement of rotation and translation thousands of times a day.

What are the TMJ disorders?
The diseases affecting the ATM are called Mandibular Cranial Disorders (DCM). They include disorders involving masticatory musculature (extracapsular disorders), those of the temporomandibular joint and associated structures (intracapsular disorders), or both.

What are the symptoms?
The symptoms associated with mandibular skull disorders are multiple:
Pain radiated to the face, to the area of ​​the ear, neck and shoulders;
"Click" or crackles during the opening and closing of the mouth;
Limitation in mouth opening;
Fatigue of the muscles of the face;
Muscle tensive headache;
Difficulty in chewing or sudden discomfort in closing, as if the upper and lower teeth do not "mesh" correctly;
Tinnitus and / or tinnitus;

What are the causes?
It is recognized that mandibular skull disorders have a multifactorial origin. The factors described below can therefore represent, from one patient to another, predisposing or triggering factors:
Condyle-meniscal incoordination;
Structural alterations of the articular surfaces;
Flogistic changes (eg arthrosis);
Dental malocclusions: contact defects between teeth during closure;
Parafunctions: the grinding or the clenching of the teeth;
Night apnea.

How are TMJ disorders diagnosed?
Because the symptoms of DCM are multiple and may be common to other pathological conditions, such as sinusitis, the accurate medical and dental history of the patient, the clinical examination and instrumental examinations are essential for a correct diagnosis. In our study we use the latest technology that, combined with experience and clinical skills, allow you to perform a gnathological analysis aimed at solving the problem.

What are the treatments?
The therapy will be set based on the data emerged from the diagnosis. The treatment is usually based on the combined use of specific physiotherapeutic maneuvers and occlusal plaques. Both the physiotherapeutic treatment and the design of the occlusal plate are closely related to the type of diagnosed disease.

*Translated with Google translator. We apologize for any imperfection

By Dott. Gaetano Calesini

Dr. Gaetano Calesini, specialist in Odontostomatology, is a medical figure of international importance. She began her professional career as a dental technician and for over 39 years has directed and coordinated her multidisciplinary group of specialist dentists in Rome.
Dr. Calesini has been a lecturer at several Italian universities, is Past President of the Italian Academy of Prosthetic Dentistry, Honorary Member of the Italian Society of Conservative Dentistry, an active member of the Italian Society of Osseointegration and other important international scientific societies.
Dr. Calesini is specialized in the treatment of particularly complex clinical cases, in the resolution of situations in which previous dental treatments have failed and / or in the treatment of patients with high expectations.
The multidisciplinary approach, perfected over the last decades, allows to rationalize the times and costs of the therapies even in patients not residing in Rome.

*Translated with Google translator. We apologize for any imperfection

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