Maxillary arthritis

TMJ arthritis is an inflammatory (infectious or non-infectious) disease of the joint connecting the lower jaw to the temporal bone of the skull. In the acute stage, TMJ arthritis proceeds with sharp pain in the affected joint, extending to the ear and temple; swelling and flushing of the skin over the joint; the impossibility of complete closure of the dentition and the restriction of opening the mouth; general temperature reaction. Diagnosis of arthritis includes the analysis of medical history, palpation of the joint area, radiography and CT of the TMJ. In the treatment of TMJ arthritis, jaw immobilization, antibiotics, NSAIDs, chondroprotectors, intraarticular injections of corticosteroids, physiotherapy, myogymnastics are used.

Overview

TMJ arthritis is an acute or chronic inflammation of the structural elements of the temporomandibular joint, accompanied by a violation of its function. In the general structure of TMJ diseases, arthritis is 6-18% and is statistically more common in young and middle-aged people. Given the etiology and course of TMJ arthritis, its treatment may fall within the purview of dentistry, traumatology, rheumatology.

TMJ is a paired joint formed by the temporal and mandibular bones and providing movement of the lower jaw. The main elements of the temporomandibular joint include the articular head of the mandible, the mandibular fossa of the temporal bone, articular disc, articular tubercle, articular capsule and ligamentous apparatus. In the initial stage, inflammation captures the joint capsule and periarticular tissues. In the future, the inflammatory process extends to the synovial membrane, articular surfaces and areas of bone tissue, accompanied by razvolnenie and melting of the cartilage, the formation of connective tissue in the joint cavity. Arthritis of the temporomandibular joint can result in muscle contracture, deforming arthrosis, fibrous or bone ankylosis of TMJ.

TMJ Arthritis Classification

Considering the underlying causes of the inflammatory process, infectious and non-infectious TMJ arthritis are distinguished. In turn, TMJ infectious arthritis is divided into non-specific and specific (tuberculosis, syphilitic, gonorrhea, actinomycotic, etc.). Arthritis of TMJ of non-infectious origin can be traumatic, rheumatoid, reactive in origin.

TMJ arthritis may have an acute or chronic course; while the acute stage may be accompanied by serous or purulent inflammation.

Causes of TMJ Arthritis

In infectious arthritis, pathogens can enter the TMJ cavity by hematogenous, contact or direct route. Hematogenous infection in the joint tissue is possible with scarlet fever, measles, tonsillitis, diphtheria, typhoid, salmonellosis, brucellosis, gonorrhea, tuberculosis, syphilis, actinomycosis, etc.

Contact infection of the TMJ can occur with purulent mumps, otitis media, mastoiditis, osteomyelitis of the lower jaw or temporal bone, a boil of the external auditory canal, an abscess and phlegmon of the parotid chewing area. Direct infection is most often associated with a TMJ puncture, a fracture of the lower jaw, a gunshot wound, etc.

TMJ reactive arthritis is aseptic in nature (there are no pathogens in the affected joint), but have a direct pathogenetic relationship with the infection. TMJ reactive arthritis can develop against the background of chlamydia, ureaplasmosis, rubella, viral hepatitis, enteritis, meningococcal infection, etc.

In rheumatoid arthritis, a TMJ lesion occurs simultaneously with other joints (knee, hip, shoulder, small joints of the hands and feet, etc.) or shortly after them. Acute traumatic arthritis of the TMJ can be associated with mechanical damage to the joint with a bruise, a blow to the jaw, and excessive opening of the mouth; often combined with hemarthrosis. In infectious and traumatic lesions, as a rule, inflammation of the TMJ is one-sided; with rheumatism – bilateral.

Symptoms of TMJ Arthritis

The leading symptom in the clinic for acute arthritis of the TMJ is a sharp pain in the joint area, which intensifies when you try to open your mouth or move your jaw. As a rule, the pain is local, pulsating in nature, but it can often radiate to the tongue, ear, nape, temple. With arthritis of the TMJ, the patient can open his mouth no more than 5-10 mm; when you try to open your mouth, the lower jaw moves to the sick side. In the projection of the affected temporomandibular joint, hyperemia of the skin, soft tissue edema, and pain on palpation are determined. With the accumulation of serous exudate in the joint cavity, patients complain of a feeling of fullness in the jaw, the inability to close teeth tightly.

Purulent arthritis of the TMJ occurs with symptoms of fever, the formation of a dense infiltrate in the joint area, hyperesthesia and hyperemia of the skin. Patients complain of acute local pain, hearing loss, dizziness. On examination, a narrowing of the external auditory canal is revealed. Perhaps the formation of abscesses opening in the parotid region or external auditory canal.

In chronic arthritis of the TMJ, pain is manifested to a lesser extent; leading complaints are joint stiffness of varying severity, a feeling of stiffness in the joint, glossalgia, tinnitus. The amplitude of the opening of the mouth is 2-2,5 cm; with movements of the jaw, a crackling and clicking in the joint is noted. Deformation of the articular head and cortical plate of the cavity during chronic inflammation can lead to subluxation and dislocation of the lower jaw.

TMJ rheumatoid arthritis occurs with multiple arthralgia, polyarthritis, and fever; at the same time, acquired heart defects can be detected in patients. A laboratory examination reveals positive rheumatic tests (CRP, sialic, diphenylamine, etc.).

In case of traumatic arthritis of the TMJ, the moment of injury is accompanied by sharp pain in the joint, followed by trismus and restriction of passive and active movements of the lower jaw. Often with traumatic injuries, a rupture of the ligamentous apparatus, hemorrhage in the joint occurs, which further leads to ankylosis of the temporomandibular joint.

Arthritis of TMJ of a specific etiology has a chronic course. So, with tuberculous arthritis of the TMJ, fistulous passages often develop, a secondary bacterial infection joins. Diagnosis is facilitated by a history of contact with a TB patient, positive tuberculin tests, characteristic changes in the lungs.

The course of gonorrheal arthritis of the TMJ is acute, with pain and infiltration in the joint, subfebrile condition, intoxication. TMJ syphilitic arthritis is characterized by the formation of gum in the periarticular tissues, the formation of contracture of the lower jaw. With actinomycotic arthritis of the TMJ, periodic exacerbations of the chronic process also lead to the development of pronounced contractures of the masticatory muscles.

Diagnosis of TMJ Arthritis

The main method for verifying the diagnosis is radiography, computed tomography of the TMJ or CBCT of the temporomandibular joint. The defining radiological sign of acute TMJ arthritis is the expansion of the joint space; chronic arthritis – narrowing of the joint space, the appearance of marginal usuras of the joint head and articular tubercle.

Acute TMJ arthritis requires differentiation with trigeminal neuralgia, acute otitis media, pericoronaritis, and other diseases associated with arthropathies (gout, dermatomyositis, Behcet’s disease, ankylosing spondylitis, etc.). In determining the etiology of specific TMJ arthritis, the decisive role belongs to PCR and ELISA.

TMJ Arthritis Treatment

Treatment of any type of TMJ arthritis begins with the immobilization of the jaw and rest of the affected joint for 2-3 days. This is achieved by applying a sling bandage to the lower jaw or splint and the interdental plate to separate the bite, prescribing a semi-liquid diet.

With traumatic arthritis of the TMJ in the first 2-3 days, the formulation of cold compresses, the administration of analgesics are shown; in the future – physiotherapeutic treatment (UHF, electrophoresis, mud therapy, diadynamic currents), myogymnastics and massage of the masticatory muscles are performed.

Therapy of acute TMJ acute arthritis is carried out by prescribing NSAIDs, antibiotics, intra-articular injections of corticosteroids, chondroprotectors, physiotherapy (laser therapy, magnetotherapy, ultraphonophoresis, mud therapy, paraffin therapy, ozokerite therapy), acupuncture. With purulent arthritis of the TMJ, an emergency opening and drainage of the joint cavity through an external incision is performed.

In chronic arthritis of the TMJ, it is important to conduct courses of massage, physiotherapy, physiotherapy, sanitation of the nasopharynx and oral cavity, and rational prosthetics. The treatment of specific and rheumatic arthritis of the TMJ is carried out by appropriate specialists, taking into account the underlying disease.

Forecast and prevention of TMJ arthritis

TMJ arthritis is a serious disease that requires immediate medical attention. The outcome of acute infectious and traumatic arthritis is usually favorable; chronic inflammation of the TMJ often results in the formation of bone ankylosis, requiring complex surgical treatment.

The prevention of TMJ arthritis involves the timely rehabilitation of chronic purulent foci and the treatment of acute infectious diseases, the prevention of joint injury, the prevention and elimination of specific infections.

Arthritis of the maxillofacial joint, 7 symptoms requiring immediate treatment

As you know, if a person does not hurt any organ, then he does not think about it at all. What to think about him? That’s when he gets sick – then all thoughts begin! Today we consider the arthritis of the maxillofacial joint, the symptoms and treatment of this ailment. It often affects young and middle-aged people.

Hello my dear readers! I’m Svetlana Morozova. The temporomandibular joint (TMJ) is the only movable joint of the skull and is located in the maxillofacial region, and therefore sometimes the name “maxillofacial joint” can be found. He does not attract our attention until he is seized by an ailment.

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And then all thoughts focus on him, because it’s simply impossible to eat, drink, or even speak.

Arthritis of the maxillofacial joint, symptoms and treatment: what we feel

  • Severe pain when trying to open your mouth. That is where it usually starts. Pain can torment and at rest, it is so severe that it is impossible to sleep at night. It can be given to the neck, ear, nape, or temporal region. Unlike trigeminal neuralgia, TMJ arthritis causes local pain (in front of the ear) and throbbing, while the affected trigeminal nerve gives an unbearable pain covering the entire face and looks like an electric shock, and it lasts only a few seconds.
  • Restriction of the movement of the jaw: it is impossible to open the mouth w />
  • Redness in the affected joint.
  • Hearing impairment, dizziness (when inflammation has affected the inner ear). Congestion of both ears, even if the inflammation is unilateral.
  • If the process has become chronic, the above symptoms become dull, but others are added: clicking and crunching in the joint during its movement (the so-called “joint noise”), stiffness in the morning, dull, aching pains, sometimes there is constant noise in the ears.

In any case, even if it does not seem very difficult for you, you need to see a doctor. Otherwise, inflammation can drag on and become chronic or spread to neighboring tissues and organs.

Untreated chronic arthritis often turns into TMJ arthrosis: degeneration of articular cartilage, which is almost impossible to cure!

What to do in addition to prescribed by your doctor

Pain medication to relieve pain and nerves to rest.

Provide rest to the diseased organ. For this, a sling bandage is applied (see photo). From the name it’s clear what it is: a strip of fabric, longitudinally incised at both ends. It is advised to use not even a bandage for it, but a denser fabric, for example, cotton. The middle of the “sling” is superimposed from below on the lower jaw, and the ends are tied on the head. The dressing must be kept for several days.

If the TMJ lesion occurs due to an injury (shock or bruise), the first day you need to apply cold to the joint to relieve swelling and reduce hemorrhage, if any. In the future, but not earlier than on the third day, warming dressings should be applied to absorb the exudate.

If the general temperature of the body suddenly rises, warming compresses cannot be used: perhaps a purulent process is going on in the joint. It is necessary to immediately consult a doctor, or better, call him at home!

If the inflammation of the TMJ is secondary and occurs after otitis media, tonsillitis, rheumatism or infectious diseases (influenza, tonsillitis, tuberculosis, etc.), the first disease should be cured by first contacting an ENT specialist, rheumatologist or dentist for help.

It is possible the doctor will prescribe antibiotics that you should not neglect in order not to get an even worse complication.

Hospitalization and surgery are sometimes required, but in most cases you can do without it.

To support our body, it is necessary to take vitamin preparations, especially vitamin C. Food should be liquid or rubbed on a blender so that there is no need to actively work with the jaws. The diet should contain everything necessary for correction: proteins, fats and carbohydrates. Eat (or rather, drink liquid food) you need more often and in small portions.

Well restores mobility medical gymnastics. It should be dealt with when the main treatment is already completed. For the jaw it is this: you need to close and open your mouth overcoming resistance.

Word – Traditional Medicine

It in no case can replace the main treatment that your doctor will prescribe, but it can significantly help recovery.

Ins >

Mix everything in equal parts, brew 1 tablespoon of the collection in a glass of boiling water, leave for 20-25 minutes, strain and drink 3 tablespoons 2 times a day before meals.

Second anti-inflammatory collection:

  • calendula flowers;
  • chamomile flowers;
  • yarrow grass;
  • rosemary leaf.

Brew and accept as well as the previous collection.

Outwardly, apple cider vinegar with turpentine in a ratio of 1: 1 can be rubbed into the affected area. After applying a light warming compress.

A traditionally used vodka compress: per 100 ml of vodka, black radish juice (one medium-sized root crop). Rub better at night, followed by a warming compress.

We help many people with ointment with bee venom (if there is no allergy) or fir oil with a warming compress for the night.

My dear friends! Be attentive to yourself and your health, do not dismiss, expecting that everything will “pass” by itself. We ourselves and our loved ones are the most precious thing we have in this world!

On this, I finish the article: “Arthritis of the maxillofacial joint, symptoms and treatment”. I wish you all good health!

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Arthritis of the jaw joint, what is it and how to treat it

A pathology known as jaw arthritis is considered quite rare. The disease can provoke dangerous complications, and should be subjected to high-quality therapy at the initial stage of its development.

Features of the disease

Jaw arthritis with equal frequency affects patients of both sexes. It is more often diagnosed in middle-aged men and women who are prone to disorders of the musculoskeletal system. Sometimes pathology is found in children or adolescents.

The disease always provokes the development of inflammation. At the initial stage, the joint bag and surrounding soft tissues become inflamed. Progressing, the disease covers articular surfaces, cartilage, causes cartilage degeneration, the formation of connective tissue foci.

After some time, the pathology tends to acquire an aggressive course. In this case, dystrophic changes occur in the affected area. Frequent phenomena are contractures (limited movement), ankyloses (insufficient joint mobility). In severe forms of the disease, muscle tissue is deformed and affected.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Types of violation

The main variants of the disease are arthritis of the maxillary, temporomandibular joint. Pathology can have a different nature (infectious, non-infectious), be acute or chronic.

Basically, the violation takes on a unilateral course. Extremely rare pathology covers both sides of the jaw.

Characteristic symptomatology

Common symptoms of a maxillary form of the disease are:

  • soreness caused by the development of a degenerative process, prone to morning worsening;
  • stiffness of movements, manifested by moderate discomfort or complete inability to open the mouth;
  • swelling of the mucous membrane of the cheeks, observed upon the transition of the disease into a purulent form;
  • discomfort that occurs when feeling the problem area.

In addition to the symptoms mentioned, jaw arthritis is sometimes accompanied by a change in the normal color of the skin. If the pathology is gouty, the epidermis becomes plum. In infectious arthritis, pineal seals often form near the problem joint.

Maxillary arthritis tends to proceed for a long time without severe symptoms, and manifest itself by characteristic signs only at a late stage. In acute violation, the symptoms are pronounced. Often they are accompanied by a headache, a feeling of fullness, a rise in body t, and a deterioration in auditory perception. If the disease has become chronic, the jaw may crack and click. At the same time, the patient suffers from aching pain, experiences increased fatigue.

Bone structures are often deformed at the first stage of the development of pathology and are detected due to x-rays. If the disease is started, the displacement of the jaw becomes obvious, becomes noticeable from the side.

Causes of the disease

If jaw arthritis is disturbing, the causes of the pathology are often associated with an infectious lesion of the joint tissue. The disease is often caused by a certain variety of harmful microbes. Sometimes – several types of pathogenic microorganisms at once.

The development of pathology can be associated with the following factors:

  • damage to the jaw resulting from a stroke or an unsuccessful opening of the mouth;
  • poor-quality treatment of diseases of a viral or bacterial nature (influenza, osteomyelitis, chlamydial infection);
  • fractures of the jaw joint;
  • the presence of “heavy” carious teeth in the mouth;
  • chronic pathologies of the musculoskeletal system;
  • significant hypothermia of the body.

In some cases, jaw arthritis is associated with impaired metabolism, systemic lupus erythematosus, gout, rheumatoid arthritis, osteoporosis. Cases are known when the violation manifested itself after a diagnostic or therapeutic puncture of the joint cavity.

The following pattern exists. Jaw arthritis of an infectious or traumatic nature predominantly has a one-sided character. If the disease is associated with rheumatism, its course is often bilateral.

What complications is a pathology dangerous?

When arthritis of the jaw joint occurs, the consequences do not develop in all patients. At an early stage, the disease goes away without dangerous complications, and can be safely treated thanks to timely medical intervention. If the patient has a running disorder, the consequences can take the form of:

  • ankylosis, characterized by proliferation of bone, connective and fibrous tissue;
  • meningitis, which causes inflammation of the meninges;
  • destructive processes in the joint;
  • complete immobilization of the jaw.

In severe cases, the risk of developing sepsis is increased – a general infection of the blood and the whole body, requiring doctors to seriously fight for the patient’s life.

Conducting diagnostics

A diagnosis of jaw arthritis requires consultation with several specialists. Before confirming the presence of pathology, the patient is examined by a dentist, rheumatologist, traumatologist, otolaryngologist, orthopedist, surgeon. Consultation with a TB specialist and an infectious disease specialist is also needed.

An important role in the diagnosis is given to laboratory blood tests. The presence of pathology is indicated by elevated ESR, rheumatoid factor.

To determine the degree of joint damage and the characteristics of the course of the disease, hardware diagnostics are prescribed. The main procedures are:

  • X-ray, revealing dystrophic processes in the bone;
  • Ultrasound, which helps to detect fluid in the joint field;
  • CT scan, giving maximum information about the condition of the diseased organ, allowing visualization of the affected areas of the soft tissues;
  • MRI that accurately determines the stage of the disease, the presence of synovial fluid.

In order to conduct differential diagnosis, ELISA and PCR are used. These methods make it possible to distinguish jaw pathology from inflammation of the trigeminal nerve, acute otitis media, arthropathy.

Medication

Patients with a diagnosis of “jaw arthritis” treatment is prescribed after clarifying the causes of damage to bone structures. The choice of drugs depends on the factor that provoked the pathological condition:

  1. In case of infection, antibiotics, antifungals (Tetracycline, Amoxicillin, Fluconazole) are required.
  2. Upon receipt of jaw injuries, non-steroidal and pain medications are prescribed (Nimesil, Diclofenac, Morphine, Paracetamol).
  3. Against the background of rheumatic diseases, there is a need for steroids, cytostatics (Prednisolone, Methotrexate, Cyclophosphamide).

The best results for jaw arthritis medications are provided for acute pathology. If the disease has become chronic, the main task of the doctor is to alleviate the condition of the patient and prevent further aggravation of symptoms. When chronic violations of the patient needs regular medical examinations, physiotherapy, exercise therapy. By agreement with the attending physician, folk remedies for jaw arthritis can be used.

When surgery is needed

If the disease is accompanied by purulent processes, the patient is prescribed surgery. Also, the operation is necessary in the following situations:

  • with insufficient effectiveness of drug therapy;
  • with a significant limitation of joint mobility;
  • in case of severe pain that cannot be eliminated by conventional means.

The main methods of operation are discectomy, reconstructing, arthroscopy. Sometimes there is a need for total arthroplasty. Surgery may be performed under local or general anesthesia.

How to prevent the disease – preventive measures

Prevention of jaw arthritis includes:

  • high-quality treatment of chronic purulent foci;
  • regular oral hygiene;
  • prevention of jaw injuries;
  • refusal to eat too hard food;
  • safe dental prosthetics;
  • periodic intake of special complexes to strengthen bone tissue.

It is possible to prevent jaw joint disease due to the complete elimination of specific infections (chlamydia, gonorrhea), and prevention of severe hypothermia. It is important to undergo examinations at the dentist 1-2 times a year, to completely correct malocclusion.

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What treatment is prescribed for arthritis of the jaw: drugs, physiotherapy, special exercises

In modern medical practice, arthritis of the jaw joint is not so common, however, this pathology requires special attention, since it can lead to negative consequences and complications up to disability. The treatment of jaw arthritis is a long, laborious process, requiring an integrated approach, sometimes up to surgery. This is what we will consider in this article.

Factors that a doctor considers when prescribing treatment

Never be treated on your own. This is fraught with serious complications. What doctor to go to? First of all, you need to run to the rheumatologist. Depending on the causes of the pathology, you may need the help of a TB doctor, traumatologist, neurologist, infectious disease specialist. In some situations, you need to contact the dentist to eliminate bite defects.

The doctor will carefully study the clinical picture of the disease, conduct a diagnosis, on the basis of which he will prescribe an effective therapy based on:

  • degree and neglect of pathology;
  • reasons for the development of the problem;
  • age of the patient;
  • sensitivity of the patient to drugs;
  • contraindications;
  • the presence of complications.

An acute manifestation of arthritis of the jaw needs immediate treatment, which is primarily aimed at eliminating the focus of inflammation, reducing pain, as well as restoring health. Folk remedies are not only powerless, but also dangerous, since they can lead to a worsening of the patient’s condition, therefore, at the first signs of inflammation, you should definitely go to the doctor.

Medical treatment of the disease

How to treat jaw arthritis? Therapy must be comprehensive. It includes:

  1. The application of a sling band for at least three days, which fixes the lower jaw for maximum peace of mind.
  2. The use of anti-inflammatory drugs (NSA >

Physiotherapy

This treatment is based on the following procedures:

  • Magnetotherapy. It is able to improve blood circulation in the jaw joint, normalize metabolic processes.
  • Mud treatment. To do this, take the healing mud, heat it to 40 degrees, and then apply it to the inflamed joint (at least 3 cm). Cover the problem area with polyethylene and warm material. Hold the compress for half an hour, and then wash off. The treatment course should last at least 10 days.
  • Cryotherapy, which will relieve swelling, pain, redness of the skin, and also improve the patient’s condition.
  • Ultrasound. It has a biochemical, thermal effect on the affected area. Also, using this procedure, you can relieve stagnation, inflammation, spasms of the masticatory muscles.
  • Laser treatment, thanks to which inflammatory processes are easily eliminated.
  • Acupuncture. This procedure is able to eliminate muscle spasm, as a result of which recovery processes are activated in the joint.
  • High-quality therapeutic massage that improves blood circulation.
  • Paraffin therapy.

Important. All of the above procedures should not be performed with acute jaw arthritis. In exceptional cases, some of them are prescribed by a doctor.

Special physical education for the jaw

It is important to perform special exercises to restore joint mobility. Here is one of these exercises for maxillary arthritis:

  • With your fist, block the movement of the lower jaw.
  • You open your mouth exclusively with the upper part.
  • An exercise is done for 2 minutes up to 3 times a day.
  • In order to avoid pain during its execution, smear the joint with healing ointment or camphor oil before occupation.

Surgical intervention

If purulent arthritis is found in the patient, then in this case it is necessary to urgently open the joint cavity and install drainage through the external incision. This cannot be done at home, but only in a hospital setting.

In case of a jaw injury, due to which arthritis arose, it is necessary to apply a cold compress to the affected joint for several days, as well as take analgesics and supplement everything with physiotherapy. It is imperative to provide the joint with complete peace. During this period, a sparing diet should be followed – you need to eat liquid and puree food.

Forecast and preventive measures

Maxillary arthritis is a very serious pathology that requires urgent medical attention. The prognosis of the disease is favorable. However, bone ankylosis is possible, which can only be treated by surgery.

With infectious arthritis, there is a risk of sepsis. And since the jaw is located close to the brain, an untreated disease can lead to the death of the patient.

To prevent such complications, do the following:

  • Treat all acute and chronic infections to the end.
  • Timely eliminate purulent foci.
  • Prosthetics only in trusted clinics.
  • In the chronic form of arthritis of the jaw, qualitatively treat nasopharyngeal diseases.
  • Avo >

Despite the fact that the entire treatment of the pathology is most often carried out at home, the doctor must always monitor the condition of the affected joint. Self-medication is strictly prohibited – remember this. Only in this case you will avoid unpleasant consequences for your health.

TMJ Arthritis

TMJ arthritis is an inflammatory (infectious or non-infectious) disease of the joint connecting the lower jaw to the temporal bone of the skull. In the acute stage, TMJ arthritis proceeds with sharp pain in the affected joint, extending to the ear and temple; swelling and flushing of the skin over the joint; the impossibility of complete closure of the dentition and the restriction of opening the mouth; general temperature reaction. Diagnosis of arthritis includes the analysis of medical history, palpation of the joint area, radiography and CT of the TMJ. In the treatment of TMJ arthritis, jaw immobilization, antibiotics, NSAIDs, chondroprotectors, intraarticular injections of corticosteroids, physiotherapy, myogymnastics are used.

Overview

TMJ arthritis is an acute or chronic inflammation of the structural elements of the temporomandibular joint, accompanied by a violation of its function. In the general structure of TMJ diseases, arthritis is 6-18% and is statistically more common in young and middle-aged people. Given the etiology and course of TMJ arthritis, its treatment may fall within the purview of dentistry, traumatology, rheumatology.

TMJ is a paired joint formed by the temporal and mandibular bones and providing movement of the lower jaw. The main elements of the temporomandibular joint include the articular head of the mandible, the mandibular fossa of the temporal bone, articular disc, articular tubercle, articular capsule and ligamentous apparatus. In the initial stage, inflammation captures the joint capsule and periarticular tissues. In the future, the inflammatory process extends to the synovial membrane, articular surfaces and areas of bone tissue, accompanied by razvolnenie and melting of the cartilage, the formation of connective tissue in the joint cavity. Arthritis of the temporomandibular joint can result in muscle contracture, deforming arthrosis, fibrous or bone ankylosis of TMJ.

TMJ Arthritis Classification

Considering the underlying causes of the inflammatory process, infectious and non-infectious TMJ arthritis are distinguished. In turn, TMJ infectious arthritis is divided into non-specific and specific (tuberculosis, syphilitic, gonorrhea, actinomycotic, etc.). Arthritis of TMJ of non-infectious origin can be traumatic, rheumatoid, reactive in origin.

TMJ arthritis may have an acute or chronic course; while the acute stage may be accompanied by serous or purulent inflammation.

Causes of TMJ Arthritis

In infectious arthritis, pathogens can enter the TMJ cavity by hematogenous, contact or direct route. Hematogenous infection in the joint tissue is possible with scarlet fever, measles, tonsillitis, diphtheria, typhoid, salmonellosis, brucellosis, gonorrhea, tuberculosis, syphilis, actinomycosis, etc.

Contact infection of the TMJ can occur with purulent mumps, otitis media, mastoiditis, osteomyelitis of the lower jaw or temporal bone, a boil of the external auditory canal, an abscess and phlegmon of the parotid chewing area. Direct infection is most often associated with a TMJ puncture, a fracture of the lower jaw, a gunshot wound, etc.

TMJ reactive arthritis is aseptic in nature (there are no pathogens in the affected joint), but have a direct pathogenetic relationship with the infection. TMJ reactive arthritis can develop against the background of chlamydia, ureaplasmosis, rubella, viral hepatitis, enteritis, meningococcal infection, etc.

In rheumatoid arthritis, a TMJ lesion occurs simultaneously with other joints (knee, hip, shoulder, small joints of the hands and feet, etc.) or shortly after them. Acute traumatic arthritis of the TMJ can be associated with mechanical damage to the joint with a bruise, a blow to the jaw, and excessive opening of the mouth; often combined with hemarthrosis. In infectious and traumatic lesions, as a rule, inflammation of the TMJ is one-sided; with rheumatism – bilateral.

Symptoms of TMJ Arthritis

The leading symptom in the clinic for acute arthritis of the TMJ is a sharp pain in the joint area, which intensifies when you try to open your mouth or move your jaw. As a rule, the pain is local, pulsating in nature, but it can often radiate to the tongue, ear, nape, temple. With arthritis of the TMJ, the patient can open his mouth no more than 5-10 mm; when you try to open your mouth, the lower jaw moves to the sick side. In the projection of the affected temporomandibular joint, hyperemia of the skin, soft tissue edema, and pain on palpation are determined. With the accumulation of serous exudate in the joint cavity, patients complain of a feeling of fullness in the jaw, the inability to close teeth tightly.

Purulent arthritis of the TMJ occurs with symptoms of fever, the formation of a dense infiltrate in the joint area, hyperesthesia and hyperemia of the skin. Patients complain of acute local pain, hearing loss, dizziness. On examination, a narrowing of the external auditory canal is revealed. Perhaps the formation of abscesses opening in the parotid region or external auditory canal.

In chronic arthritis of the TMJ, pain is manifested to a lesser extent; leading complaints are joint stiffness of varying severity, a feeling of stiffness in the joint, glossalgia, tinnitus. The amplitude of the opening of the mouth is 2-2,5 cm; with movements of the jaw, a crackling and clicking in the joint is noted. Deformation of the articular head and cortical plate of the cavity during chronic inflammation can lead to subluxation and dislocation of the lower jaw.

TMJ rheumatoid arthritis occurs with multiple arthralgia, polyarthritis, and fever; at the same time, acquired heart defects can be detected in patients. A laboratory examination reveals positive rheumatic tests (CRP, sialic, diphenylamine, etc.).

In case of traumatic arthritis of the TMJ, the moment of injury is accompanied by sharp pain in the joint, followed by trismus and restriction of passive and active movements of the lower jaw. Often with traumatic injuries, a rupture of the ligamentous apparatus, hemorrhage in the joint occurs, which further leads to ankylosis of the temporomandibular joint.

Arthritis of TMJ of a specific etiology has a chronic course. So, with tuberculous arthritis of the TMJ, fistulous passages often develop, a secondary bacterial infection joins. Diagnosis is facilitated by a history of contact with a TB patient, positive tuberculin tests, characteristic changes in the lungs.

The course of gonorrheal arthritis of the TMJ is acute, with pain and infiltration in the joint, subfebrile condition, intoxication. TMJ syphilitic arthritis is characterized by the formation of gum in the periarticular tissues, the formation of contracture of the lower jaw. With actinomycotic arthritis of the TMJ, periodic exacerbations of the chronic process also lead to the development of pronounced contractures of the masticatory muscles.

Diagnosis of TMJ Arthritis

The main method for verifying the diagnosis is radiography, computed tomography of the TMJ or CBCT of the temporomandibular joint. The defining radiological sign of acute TMJ arthritis is the expansion of the joint space; chronic arthritis – narrowing of the joint space, the appearance of marginal usuras of the joint head and articular tubercle.

Acute TMJ arthritis requires differentiation with trigeminal neuralgia, acute otitis media, pericoronaritis, and other diseases associated with arthropathies (gout, dermatomyositis, Behcet’s disease, ankylosing spondylitis, etc.). In determining the etiology of specific TMJ arthritis, the decisive role belongs to PCR and ELISA.

TMJ Arthritis Treatment

Treatment of any type of TMJ arthritis begins with the immobilization of the jaw and rest of the affected joint for 2-3 days. This is achieved by applying a sling bandage to the lower jaw or splint and the interdental plate to separate the bite, prescribing a semi-liquid diet.

With traumatic arthritis of the TMJ in the first 2-3 days, the formulation of cold compresses, the administration of analgesics are shown; in the future – physiotherapeutic treatment (UHF, electrophoresis, mud therapy, diadynamic currents), myogymnastics and massage of the masticatory muscles are performed.

Therapy of acute TMJ acute arthritis is carried out by prescribing NSAIDs, antibiotics, intra-articular injections of corticosteroids, chondroprotectors, physiotherapy (laser therapy, magnetotherapy, ultraphonophoresis, mud therapy, paraffin therapy, ozokerite therapy), acupuncture. With purulent arthritis of the TMJ, an emergency opening and drainage of the joint cavity through an external incision is performed.

In chronic arthritis of the TMJ, it is important to conduct courses of massage, physiotherapy, physiotherapy, sanitation of the nasopharynx and oral cavity, and rational prosthetics. The treatment of specific and rheumatic arthritis of the TMJ is carried out by appropriate specialists, taking into account the underlying disease.

Forecast and prevention of TMJ arthritis

TMJ arthritis is a serious disease that requires immediate medical attention. The outcome of acute infectious and traumatic arthritis is usually favorable; chronic inflammation of the TMJ often results in the formation of bone ankylosis, requiring complex surgical treatment.

The prevention of TMJ arthritis involves the timely rehabilitation of chronic purulent foci and the treatment of acute infectious diseases, the prevention of joint injury, the prevention and elimination of specific infections.

What are the symptoms and treatment of arthritis of the maxillofacial joint?

Everyone should know the symptoms and methods of treating arthritis of the maxillofacial joint, because all age and gender groups are affected by this disease.

Causes and pathogenesis

The term “TMJ arthritis” means – the inflammatory process of the temporal mandibular articular apparatus. Pathology is associated with various etiological factors, can be acute or chronic. Such a disease is characterized by characteristic symptoms, requires adequate treatment.

The temporomandibular joint is considered the most mobile part of the facial apparatus. It is involved in swallowing, chewing, speech functions, facial expression and belongs to the group of paired combined mismatched organs. The activity of the right side causes a symmetrical movement of the left in the horizontal and vertical directions. The joint is characterized by high strength and elasticity.

Synovial fluid in the joint performs several functions:

Arthritis of the temporomandibular joint is an inflammatory disease. The classification of pathology is directly related to the etiology:

  1. Traumatic arthritis is associated with a strong mechanical impact: strokes, dislocations, bruises, fractures.
  2. An infectious disease occurs due to lesions with influenza, tonsillitis, SARS.
  3. Rheumatic and rheumatoid forms are the result of hematogenous inflammation: otitis media, purulent osteomyelitis, mumps, mastoiditis.
  4. An infectious-specific type of arthritis is associated with gonococcal pathogens, mycobacteria, actinomycotics, which affected the body.

During the diagnosis, the doctor pushes off the determination of the source. If there are several, a deeper analysis of the patient’s condition is required.

Differences between acute and chronic form

Development options are based on symptoms and causes. An exacerbation of the pathology occurs due to displacement of the cartilage as a result of the injury or penetration of the infectious agent.

The patient complains of severe pain, edema begins at the site of damage. This condition manifests itself more when opening the mouth or any activity of the jaw. Arthritis of the temporomandibular joint should be immediately diagnosed and therapeutic assistance provided to the person.

The chronic form is associated with a lack of adequate treatment, the disease is protracted. Symptoms are expressed in stiffness, constant aching pain. Fact: during aging, cartilage loses elasticity due to insufficient water content. The gradual destruction of collagen leads to roughness. A change in the composition of the synovial fluid entails a destructive lesion.

clinical picture

Signs of the disease depend on the factor that triggered the disease. Each form is distinguished by its own set of symptoms, in order to successfully choose a treatment, it is important to recognize them in a timely manner.

What features have different forms of the disease:

  1. Traumatic arthritis of the jaw is accompanied by sharp pain in the joint area. The lower part is displaced, swelling occurs. Rotation in any direction is difficult.
  2. With an infectious type, stiffness is observed in the morning. Pain during movement or palpation, can radiate (give) to the head, subclavian cavities in the arm. Sealing nodules are formed in the forms of inflammation. Edema develops around the affected area. Symptoms are pronounced, the patient’s condition worsens significantly.
  3. The purulent form is characterized by subfebrile temperature, hearing is reduced, the sensitivity of the skin appears. Infiltrate in the affected area is initially small, with development reaches a large size. Diagnosed with general intoxication of the body, weakness.
  4. Symptoms of rheumatoid arthritis depend on the course of the disease. With exacerbations, pain in the temporomandibular joint is acute, movements are difficult. The temperature may rise to 38 ° C.
  5. The chronic type is characterized by constancy of discomfort, a crunch is heard during rotation. The inflammatory process fades for a while, then resume with renewed vigor.

Even taking into account the similarity of symptoms, it is important to pay attention to the general condition of the patient. Any violation in the body can lead to a risk of complications.

Principles of treatment

Regardless of the symptoms and etiology, therapeutic measures aimed at improving the condition begin with the use of a fixing brace. The dressing is applied in order to ensure peace. Also, the patient is recommended to wear an interdental plate, which allows to slightly reduce pain. Arthritis of the jaw joint must be treated based on its origin.

Important! With an infectious and purulent form, it is strictly forbidden to apply warming. With thermal effects, a favorable microflora is formed for the reproduction of pathogens.

Several types of medications are used to treat pathology.

Painkillers

Analgesics can eliminate discomfort, but do not allow you to get rid of the cause. If you do not continue treatment, the pathology will quickly develop into a chronic form.

As an analgesic, Aspirin is most often prescribed. Acetylsalicylic acid helps to remove pain, is responsible for the work of hemostasis. It has a slight antipyretic effect. The agent acts as an inhibitor of cyclooxygenase compounds. This action helps to quickly cope with the inflammatory process.

In the form of tablets, the drug for treatment is prescribed 3-4 times a day orally, 0,5-1 g after a meal. There are a number of contraindications, for which you need to be examined by a doctor. Analogues of this tool are Acekardol, Flukspirin.

Anti-inflammatory drugs

Nonsteroidal drugs are effective for arthritis because of their ability to inhibit the synthesis of prostaglandins (enzymes that cause inflammation). They cope with the manifestations of pathology, but are not intended to prevent the destruction of joints. Means eliminate pain, remove edema. The active substances do not have a catabolic effect on cartilage.

The NSAID group includes:

The traditional dosage for exacerbations is 300 mg, divided into three doses. As a supportive treatment, the doctor prescribes 150 mg three times a day.

Antibiotics

Antibiotics are prescribed depending on the type of pathogen. The drugs used for infectious and purulent forms of inflammation of the joints of the jaw are selected strictly by the doctor after analysis.

In most cases, a broad-spectrum agent is prescribed for treatment. This is a new generation of medicines:

But in a number of situations, the doctor starts from the diagnosis and prefers to use narrowly targeted formulations for each individual case.

The dosage is prescribed individually, depending on the specifics of the lesion, the development of the disease and the condition of the patient. Possible contraindications and adverse reactions must be taken into account. Usually the course of treatment is 7 days.

Fact! If the inflammatory process continues, antibiotic replacement is required, that is, a composition is selected that does not allow the pathogen resistance.

Physiotherapy

Treatment for any type of arthritis should be comprehensive. No less effective are methods using physiotherapeutic effects on the affected areas, but their implementation is possible only after relief of acute periods. What types of physiotherapy are used:

  1. Massage. Improves microcirculation, activates the ability of blood flow. Due to this, the flow of beneficial substances into the cartilage is accelerated, elasticity and mobility are restored.
  2. Ultrasound treatment. Provides spasm relief, elimination of stagnation. The result is swelling and inflammation.
  3. Laser exposure. It is aimed at eliminating inflammatory processes. During treatment, mobility is restored, calcium salts are excreted. The procedure eliminates edema and spasm.
  4. Mud applications. Enhances lymph flow, improves trophism. The restoration of jaw function is observed in the patient in a fairly short time.

Keep in mind that the most effective technique may have contraindications. This is especially true for drug regimens. Therefore, it is important to clarify the presence of allergies or concomitant pathologies in the patient.

Any inflammatory process without treatment leads to complications that affect all body systems. Arthritis of the maxillofacial joint responds well to treatment in the event of contacting a doctor in the initial stages.

A long course of pathology can develop into a chronic form, which leads to irreversible destructive changes. This is fraught with a complete loss of mobility, expressed by the asymmetry of the oval of the face. In advanced cases, the patient requires surgery and prosthetics.

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Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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