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:
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;
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.