What is arthrosis of the jaw joint and how this ailment to treat
Arthrosis is a fairly well-known disease that affects the cartilage tissue of various joints. The initial stage is characterized by slight aching pains in the joints. If a person does not pay attention to them, then in a few years you can easily find yourself in a wheelchair or on the operating table. Osteoarthritis affects various types of joints, so the consequences of the disease may be different.
This disease, like arthrosis of the jaw joint, can deprive a person of the opportunity to talk, sing, chew food, and even affects hearing organs. With age, the percentage of patients with this type of arthrosis is growing steadily. In patients who noted the half-century anniversary, this disease occurs in almost 60% of cases, and after 70 years, the indicators move to 100%.Joints can be affected and in childhood( secondary arthrosis), no one is immune from arthrosis and in 30 years.
Thanks to the temporomandibular joint, people can perform several types of jaw movement: lowering, displacement, extension. If the mobility of the joint is disturbed, a person can not reproduce sounds( say, sing), eat, or chew movements in part or in full. These problems will be accompanied by pain syndrome. There will be such phenomena as yawning or sneezing.
Why and where it hurts with jaw arthrosis
This disease often causes pain. This is due to the fact that the tissues that form the joint( cartilaginous, bone and connective) have become very thin. For this reason, the jaw function is limited. Here are a few groups of factors that, for various reasons, can contribute to the development of the disease:
- surgery and jaw injuries;
- dental problems: malocclusion, absence of teeth( completely or partially);
- genetic factor;
- chronic inflammation in the joint;
- violation of the proportions of the contours of the face.
Primary arthrosis of the maxillofacial joint occurs closer to 40 years, and more often in women than in men. Arthrosis can be absolutely painless against diabetes mellitus, thyroid disease or metabolic disorders. Secondary arthrosis is a consequence of injuries, impaired vascular system or various pathologies. This form can occur even in children.
What symptoms should I look for?
What manifestations accompany jaw arthrosis? Dangerous signals are the following problems:
- Chest pain on one side of the jaw( provided that there are no sick teeth and acute caries).
- A crunch or clicks in various kinds of jaw movements.
- Pain syndrome after prolonged exercise( speaking, singing, chewing) or, conversely, after the end of the period of passivity( night sleep).
- Change in severity of hearing( concomitant symptom).
- Changing the motor activity of the jaw( hard to open the mouth widely).
- Painful manifestations of jaw muscles with pressure( can apply to the entire jaw, eye area or ears).
The disease should not be left to chance. Having found out at least two signs, it is necessary to address to the expert for the subsequent diagnostics. To confirm the symptoms and establish an accurate diagnosis, the doctor can assign a radiograph and computed tomography to a patient with characteristic signs of arthrosis.
Arthrosis of the jaw joint requires complex therapy, which is determined by the stage of the development of the disease. So, at the initial stage, arthrosis can be treated with diets, proper regimen and various physiotherapy procedures. Restrictions are introduced for long conversations and singing. It will be necessary to get rid of bad habits: it is undesirable to use chewing gum or gnaw nails.
But, unfortunately, the patient often delays with the reference to the doctor, and then, as a rule, one must resort to medical treatment, orthopedic correction or surgical intervention. These methods not only relieve the symptoms. The effect on the joint itself is carried out, after which a complete recovery occurs.
Dietary nutrition and regime are very important for the treatment of arthrosis of the jaw joint. Since the main task of a doctor or a dietitian is to reduce the load on the joint, the patient's menu will be dominated by liquid dishes or soft food, which does not require great effort at chewing. The menu makes up a balanced meal: cereals, soups, fruits, vegetables, fish. Another thing is the way of cooking.
Fruits and vegetables for the patient with jaw arthrosis can be grinded on a grater, in a blender, baked in the oven. Meat is served in the ground form: cutlets, meatballs.
Physiotherapeutic procedures and medical treatment
The list of physiotherapeutic procedures is determined by the attending physician on the basis of symptoms. This takes into account the patient's damage to the jaw joint( type, course of the disease, its stage).Most often, to cure an ailment, use ultrasound and laser therapy, electrophoresis, microwave therapy and dynamic current.
Drugs are also needed. For the treatment of arthrosis, two groups of drugs are used. The first is a variety of pain medications that reduce the pain syndrome. They include ketarol, ketanov, ibuprofen and others. The second group provides food for the cartilaginous tissue to restore its functionality. For this, chondroprotectors are used: teraflex, chondrolon, chondroitin and others. Treatment should not stop, even if the symptoms disappear.
For arthrosis of the jaw joint, orthopedic methods are also used, such as:
- teeth correction and their shape;
- bite change;
- restoration of the functions of the maxillofacial joint.
For the treatment of arthrosis of the jaw joint use plates( for the palate and for biting), special limiter of the mouth, kapy. If the above methods do not help and the disease progresses, then surgically remove the joint or its parts, as a replacement put the implant.
Causes and symptoms of arthrosis of the mandibular joint, effective treatment
Disease of the temporo-mandibular joint arthrosis - chronic damage, destruction of the articular surfaces and meniscus * of the temporomandibular joint. Also, the disease is characterized by a slow inflammatory process and pain when chewing and swallowing food.
* Meniscus - cartilage gasket-shock absorber in the joint.
The mandibular joint, sometimes called the temporomandibular joint( abbreviated TMJ), is combined. Its main function is the movement of the lower jaw;thanks to him, a person can chew food and pronounce sounds.
Anatomically this joint consists of a combination of the joint parts of the mandible and the temporal bone, so it has a two-story structure. He performs 3 functions: shifts the lower jaw to the side, lowers it and pushes it forward.
As a result of arthrosis, there are thinning of the articular surfaces, painful sensations arise and, as a result, the restriction of chewing movements.
Causes and prevalence of the disease
Every year more and more people suffer from this disease. According to statistics, 55% of people older than 51 years and 92% older than 70 years suffer from temporomandibular arthrosis. The main reasons for which the pathology has become so common:
- lack of exercise and gymnastics;
- unbalanced or irregular meals;
- inattentive attitude to health and absence of preventive examinations at the doctor;
- adverse environmental conditions;
- abnormal changes in the chewing apparatus, which are due to an incorrect bite, the absence of large molars on the lower jaw.
For example, if the bite is broken, if you close your teeth, the head of the lower jaw can move back and slightly down. As a result, the joint gap increases and there is an excessive load on the articular surfaces of the jaw. Chewing muscles cease to function properly, and the food of the cartilaginous tissue is disturbed. As a result, the cartilage becomes less elastic, small cracks appear. Over time, the degenerative processes pass to the osseous part of the joint structures.
Endocrine diseases, diseases of the nervous system can contribute to the occurrence of an abnormal metabolism, which can also lead to arthrosis.
Symptoms of the disease
Usually arthrosis of the temporomandibular joint is chronic. Since the disease occurs unnoticed, the patient may miss his first signs. The patient may not present any complaints when examined by a doctor, but when you try to open the jaws wide in the joint area, you will hear a crunch.
When the disease goes into a chronic form, clicks and crunching can be heard at every meal and even during a conversation or yawning. After that, it becomes unpleasant or even painful to open your mouth. Painful sensations may not pass for a long time, often are noisy.
With a heavy load on the lower jaw or with hypothermia, the pain will intensify. Some patients, on the contrary, complain of pain in the morning, which decrease after active chewing food or conversation.
When a pronounced dystrophic process occurs in the joint, the physician can diagnose arthrosis for the following four symptoms:
Asymmetry of the facial lines, which can be determined by visual inspection. With arthrosis, the lower jaw is displaced toward the inflamed joint.
Limited movements of the jaw. At the initial stage of the disease, these limitations are invisible, but become very pronounced with severe deformation( sometimes it is difficult to slightly open the mouth even 1 cm).
Attachment to the inflammatory process of the periarticular tissues, because of which the nervous conductivity of the face on the side of the joint affected by the arthrosis pathologically changes: patients complain of numbness of the lips and cheeks, headache or toothache, tinnitus.
When probing the articular area, the physician can identify painful seals that appear due to changes in the ligaments or tendons that form the joint.
Methods of treatment of TMJ arthrosis
Depending on the severity of the deformity of the mandibular joint, the following therapies are used:
- Dental prosthetics or selective grinding of natural teeth. palatine plates , which maximally close the bite to the right one, can be used - thanks to them, it is possible to reduce the degenerative processes in the joint.
- Drug therapy of the disease should be performed several times a year in combination with physiotherapy methods.
- Physiotherapy is used as an independent method of treatment, and in conjunction with others. For example, electrophoresis with potassium iodide, paraffin, mud baths, ozocerite, infrared irradiation. If there are strong painful sensations, then microwave therapy is shown for several minutes( 9-11 sessions).Strong effect gives a combination of phonophoresis and electrophoresis with massage and paraffin therapy.
- It is useful to use muscular gymnastics according to Rubinov ( especially when the lower jaw is displaced).Combination of gymnastics and massage of masticatory muscles will help to normalize blood circulation in them.
- Osteoarthritis of TMJ is very amenable to treatment with laser radiation , thanks to which you can quickly remove inflammation, speed up the regeneration process and stop pain. The procedure lasts 2-3 minutes, during which the irradiation of the lower jaw and swollen joints occurs. To achieve a tangible effect, it will take at least 14 sessions.
- All patients are shown restriction of chewing load on the lower jaw, namely - exclusion from the diet of solid foods( nuts, caramels, apples).Also, you should not open your mouth too wide( for example, when yawning) or produce a lower jaw with a large amplitude.
Also prescribed diet food with the goal of normalizing purine metabolism and lowering the acidity of urine. It is recommended to completely exclude smoked and spicy foods, drinks with caffeine( tea and coffee), alcohol, chocolate. It is also important to reduce the consumption of fish and meat broths, legumes, mushrooms and other hard-to-digest products. It is useful to eat milk, eggs, vegetables, chicken, fruits and cereals.
In some cases, intraarticular administration of preparations containing high molecular weight hyaluronic acid( for example, Synoxrom) is indicated to patients with arthrosis of temporomandibular joints to eliminate the shortage of cartilage tissue. This allows you to reduce the manifestation of pain and improve the function of the joint.
With endocrine disorders, when the patient develops secondary arthrosis, it is necessary to cure these diseases. It may be necessary to normalize the amount of urate and lipid in the urine, eliminate infectious processes in the genito-urinary organs, or other causes.
If the patient has no teeth and can not make a full prosthetic repair, then with deforming dislocation of the lower jaw, it is necessary to perform surgical treatment - to increase the height of the articular tubercle to reduce mobility in the temporomandibular joint.
After the surgery, it is important to consolidate the results with the help of spa treatment, including mud and balneological procedures.
Most studies show that patients with arthrosis of the TMJ often have certain mental or neurological abnormalities, so it will be very useful for a number of patients to undergo psychotherapeutic sessions. Psychotherapy not only will favorably affect the psychological state of patients, but it can also help to remove( reduce) the symptoms of the disease.
Subsequently, patients suffering from TMJ arthrosis should be registered with a dentist.
In conclusion, it should be noted that regular exercise, adequate nutrition, regular preventive visits to the dentist significantly reduce the likelihood of developing arthrosis on the lower jaw, improve the quality of life in old age and prevent unpleasant consequences of such pathology.
Arthrosis of the jaw joint: symptoms and treatment of the disease
Arthrosis is a chronic disease that, due to one of a large number of causes, gradually destroys articular cartilage( unlike arthritis, which is an inflammatory disease).As a result, the bones forming the joint, and its ligamentous apparatus, and the muscles that strengthen the structure become involved in the pathological process.
Joint arthrosis pain
Causes of arthrosis of the joint
Conditionally the causes are divided into general, affecting the whole body, and local, proceeding in isolation in the joint or jaws.
To general include:
- metabolic diseases( including gout);
- endocrine pathology;
- disease of nerves or muscles, impaired conductivity of the pulse along the nerve endings;
- connective tissue diseases( eg, rheumatism).
- bruxism - when there is a habit of grinding your teeth in a dream;
- bite violation due to various reasons( lack of teeth, improperly selected crowns, implants and even seals);
- abnormal abrasion of the teeth;
- a large load on the joint( eg, frequent chewing of very hard foods);
- long-term arthritis - inflammation of the jaw joint.
As a result, when the process of destruction of articular cartilage begins to predominate over its restoration( regeneration), the disease manifests itself in full. This is first in the thinning of the cartilage lining the head of the lower jaw, sometimes the cartilage disappears altogether. The next stage is an attempt by the body to restore balance in the joint. Since the cartilage can not be regenerated, bone cells begin to be reconstructed and actively divided: the joint head changes in shape. As a result, the joint ceases to function normally.
How does the disease manifest itself?
Arthrosis of the jaw can go unnoticed for a long time. Then the person notes that one or more of these symptoms appeared:
- in the morning it is difficult to open the mouth, during the day it passes;
- appears crunching in the joint;
- jaw joint "snaps" in a certain position;
- there is pain in the joint( usually on the one hand) when chewing some hard or solid food, because of which a person tries to chew on one side.
Then the displacement of the lower jaw in one direction becomes noticeable, the asymmetry of the face( especially its lower half), the lip twist.
structure of damage
If you feel the muscles on the side of the aching joint, they are tense, but painless.
Unlike arthrosis, arthritis of the jaw joint symptoms is different:
- develops rapidly;
- is more common in young people( arthrosis often occurs in the elderly);
- joint hurts quite severely, the pain increases with chewing( with arthrosis, pain occurs only when chewing or talking);
- joint area swollen, can be reddened.
These symptoms are often accompanied by a rise in body temperature, lack of appetite, weakness.
How is arthrosis treated?
In cases of arthrosis of the jaw joint, treatment should be carried out in a complex, after identifying the possible cause of the disease. Such methods of treatment as orthopedic, medicamental, physical and surgical are applied.
Orthopedic methods are those when an orthodontist dentist repairs an occlusion, makes prosthetics of individual teeth or at once a whole series of teeth in order to ensure a normal and even load on both temporomandibular joints.
- To orthopedic methods include:
- Treatment aimed at restoring individual contact between the teeth. For this, selective abrasion of the teeth is often used. As a result, a smooth glide is ensured between the teeth, which is why the load on the diseased joint is reduced.
- Treatment aimed at the normalization of the whole dentition. To do this, the deformation of the dentition is corrected by orthodontic methods. If necessary, put various crowns, bridges and clasp prostheses.
- For the normalization of the position in the joint of the lower jaw head, the following methods are used: a plastic cap on the lower or upper jaw, bite plates on several teeth or side teeth, mouth opening limiters, special devices for changing the biting plane.
In cases of arthrosis of the jaw treatment is often combined: a combination of orthodontic devices with medicamental effects.
- Physiotherapy treatment includes Trilon B phonophoresis, hydrocortisone electrophoresis, 10% potassium iodide, novocaine. Thermal procedures are also used: the use of paraffin, ozocerite, infrared irradiation.
Recently, a very good effect in treatment is observed when applying low-intensity laser radiation to the joint area. Also, muscle massage in the area of soreness is also useful.
- Drug treatment is aimed at normalizing the metabolism, eliminating hormonal imbalance in endocrine diseases, reducing the level of uric acid( with gout).
In addition, methods are used such as warming the patient's joint with naftalan, a medical bile diluted 1: 4 with dimecid to normalize blood circulation.
In the treatment it is also important to follow a diet: to limit the consumption of meat( especially fatty and game), spices, alcohol, chocolate and coffee. These products contribute to a metabolic disorder. It is recommended to eat cheeses, chicken eggs, greens, carrots, apples and pears, potatoes.
Special attention is paid to gymnastics, which should recommend a specialist exercise therapy.
Arthrosis of the jaw joint: symptoms and treatment
Arthrosis of the jaw joint is a chronic disease in which degenerative and atrophic transformation of the connective tissue that forms the articular elements takes place. The disease is characterized by a persistent current and leads to a significant restriction of movements in the affected joint.
Jaw( temporomandibular, facial) joint is a paired anatomical formation, through which the lower jaw connects to the skull. The joint makes it possible to perform chewing and articulatory movements. Between the articular surfaces is fibrous cartilage, which is tightly connected to the joint capsule and divides the joint into two separate spaces, which makes it possible to move in three directions.
Causes of the disease
Jaw arthrosis develops as a result of dystrophic changes in connective tissue that forms articular surfaces. As a rule, local causes lead to this, in this case osteoarthritis is considered secondary. If it is not possible to determine the cause of the disease, then osteoarthritis is usually considered primary. Primary arthrosis is not isolated and proceeds against the background of damage to other joints. Occurs in the middle or old age, very rarely up to 40 years. Most jaw arthrosis occurs due to injuries and inflammation of the joint.
The most common reasons are:
- chronic injuries( malocclusion, bruxism) and acute( mechanical damage, prolonged forced position in treatment procedures);
- arthritis of various etiology( purulent, specific, autoimmune) both acute and chronic;
- lowering trophism of the joint( violation of innervation, inflammation of the periarticular tissues).
Almost always, arthrosis of the temporomandibular joint develops slowly. At the beginning of the illness, active complaints may be absent. At first, the patient is worried about the crunch that occurs in the joint area, when chewing food or trying to open his mouth wide( during yawning).Over time, the crunch and clicks, during the movements of the lower jaw, become audible at a distance from the patient. There is a feeling of discomfort in the affected joint, there may be pain, usually of low intensity. Pain can be described as stupid and aching. Soreness occurs after a load, hypothermia and, as a rule, increases by the end of the day. Sometimes pain and stiffness arise in the morning, immediately after awakening, and after some motor activity, its intensity decreases.
With the progression of the disease, symptoms appear that are characteristic of pronounced destructive changes in the joint. Osteoarthritis of the maxillofacial joint in later stages is characterized by the following symptoms:
- restriction of movements, sometimes barely noticeable, but more often, significantly pronounced( it happens that patients can not open their teeth, even, by 10 mm);
- appearance of facial asymmetry( visually determined that the lower jaw is displaced in the direction from which the affected joint is located);
- for palpation of the articular region, painful seals are detected, which indicates morphological changes in the ligaments and tendons involved in joint formation;
- involvement in the process of periarticular tissues, which leads to violations of the innervation of the face on the side of the joint affected by arthrosis( complaints of a feeling of numbness in the cheek or lip, pain and tinnitus, with nothing unrelated to toothache).
How to treat arthrosis?
Treatment is primarily aimed at eliminating the cause that caused the disease. Depending on the stage of the process, it can be conservative or operative.
The main conservative methods used for the treatment of arthrosis:
- Elimination of the cause of the disease. Typically, it is to correct an incorrect bite. According to the indications, use prosthetics, selective grinding of the chewing surfaces of teeth, the installation of special palatine plates, use the wearing of kapa.
- Gentle mode of loading. It is necessary to unload the joint as much as possible. To this end, the diet excludes food that requires thorough chewing. Preference is given to cereals, vegetable and fruit puree, lactic acid products. Refusal from bad habits( chewing gum, gnawing pencils, pens or nails).
- Medication therapy. Anti-inflammatory( non-steroidal and hormonal) agents are used. The treatment is aimed at arresting the pain syndrome and fighting the inflammation of the joint tissues. A good effect is provided by the use of chondroprotectors and intra-articular administration of polyvinylpyrrolidone polymer.
- Physiotherapy. Patients are prescribed a medicinal phonon and electrophoresis, galvanization, diadynamic currents, massage of masticatory muscles. If possible, spa treatment( balneogryazevye resorts).
In later stages of jaw arthrosis, when conservative methods are not effective, surgical treatment is indicated due to profound destructive changes in the joint. The main objective of surgical intervention is the restoration of the anatomical structure of the joint, using transplants.
Osteoarthritis of the temporomandibular joint: causes, symptoms, treatment
Osteoarthritis of the temporomandibular joint is a painful chronic disease in which dystrophic disorders occur in the tissues of the temporomandibular joint.
The temporomandibular joint is located near the ear and is responsible for such important functions as opening and closing the mouth( food and conversation).With its help, the lower jaw is connected to the skull.
- 6 Treatment of temporomandibular joint arthrosis
The incidence of arthrosis of the temporomandibular joint
The most commonly affected people are old age. The disease proceeds slowly, but it constantly progresses, it is considered quite persistent to the treatment. Women with arthrosis of the temporomandibular joint may suffer at a younger age.
Causes of arthrosis
There are many reasons that can lead to pathological changes in the tissues of this joint. And not only local changes( chewing apparatus, facial muscles) can provoke the development of arthrosis, but also the general pathological processes taking place in the body: disturbances in the endocrine system, infectious diseases.
To arthrosis lead:
- frequent inflammatory processes in the joint( arthritis).Arthritis, in turn, can arise due to mumps( inflammation of the parotid salivary gland), ear inflammation, osteomyelitis of the lower jaw.
- excessive and frequent joint load
- prolonged absence of lateral teeth( often large molars on the lower jaw)
- excessive pathological abrasion of the tooth tissues
- bruxism( teeth grinding during sleep), causing excessive abrasion and disrupting the normal joint and the distance between the upper and lowerTeeth floor
- Disturbance of load distribution on joint elements of joint( with incorrect bite)
- Illiterate selection of dentures or their poor quality
arthrosis With constant exposure to causal factors there are disturbances in the structure of the joint, but in the early stages of these changes are reversible, provided that compensatory ability of the temporomandibular joint tissues. That is, arthrosis develops at a time when the equilibrium between the load on the joint tissues and the degree of their endurance is disturbed. With an incorrect bite or absence of molar teeth, the joint head is displaced back and remains in this position with closed teeth. This leads to an incorrect redistribution of the load on the elements of the joint, a violation of its function and nutrition. Gradually, the cartilage, which is located on the joint surface of the moving head, collapses and gradually disappears. In the bone also there are pathological changes, cysts and pathological growths are formed. Over time, the normal outlines of the head of the lower jaw are broken, its permanent deformation occurs, and any movements acquire an asynchronous wrong character.
Symptoms of arthrosis of temporomandibular joint
Manifestations of the disease depend on the stage and neglect of arthrosis. As a rule, arthrosis begins unnoticed for the patient. Some patients are concerned about dull, constant pain. In most cases, the first symptoms of the appearance of arthrosis are a crunch, clicking at any movements in the joint. Often there is stiffness, a feeling of stiffness in the joint after a long absence of movements( after sleep, reading), which makes it difficult to do anything in it, and then the joint is, as it were, spun and developed. Characteristic displacement of the lower jaw in the sore side when opening the mouth. Such patients often chew food only on one healthy side, as chewing on the patient causes pain and discomfort. In later stages, the opening of the mouth is disturbed, which may not even be one centimeter later. Because of the persistent displacement of the jaw in the direction of the affected joint, a person can acquire asymmetrical outlines.
Methods of diagnosis of arthrosis
When referring to the "dental doctor", he necessarily conducts an examination of the oral cavity for the absence of teeth, the state of dentures, paying attention to excessive erasure and bite disorders, the possible amplitude of movements is determined.
The X-ray of the temporomandibular joint gives objective and reliable information. On it, the doctor can see a violation of the shape of the articular head of the lower jaw( with arthrosis it flattenes and decreases its height), bony proliferation in the form of spines. But the earliest and still reversible changes can be found on computer tomograms( thinning of the articular cartilage, changes in the bone, narrowing of the joint gap).
Sometimes, to distinguish arthrosis from other diseases with similar manifestations, it is necessary to perform an electromyographic study that can reveal excessive muscle tension.
Treatment of temporomandibular joint arthrosis
Treatment for this type of arthrosis is carried out in a comprehensive manner, by all possible and accessible methods. The patient is supervised by an orthopedic physician, who must determine the reasons for the overload of the joint. The initial and mandatory task is to eliminate the factors that cause arthrosis .This is done with the help of orthopedic techniques. If the contact between the teeth is broken, then they are ground, which restores the harmonious interaction of all elements of the dento-jaw system, including the temporomandibular joint. If necessary, artificial crowns and dentures are installed. The orthodontist normalizes the anomalies and deformities of the dentition( incorrect bite).If the patient has excessive abnormal abrasion with a decrease in interalveolar height, then a special plastic kappa is to be worn for 2-4 months, so that pain and discomfort quickly passes, a new interalveolar height is formed. It is mandatory to carry out a set of exercises to restore the coordination of the function of the masticatory muscles. From the methods of physiotherapeutic treatment, electrophoresis is prescribed( with potassium iodide and novocaine for the removal of inflammation and anesthesia), massage, galvanization, mud therapy and paraffin therapy. Often resorted immediately to several methods of physiotherapy. After eliminating the painful symptoms, patients with arthrosis of the temporomandibular joint are under the supervision of a dentist for a long time.