The “anchored disc phenomenon”: A proposed etiology for sudden-onset, severe, and persistent closed lock of the temporomandibular joint (original) (raw)
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Subluxation of temporomandibular joint- A clinical view
In the temporomandibular joint (TMJ) with physiological disc position, the disc rotates posteriorly on the condyle to the maximum degree and the condyle translates to the maximum degree, which occurs simultaneously at the maximum mouth opening movement. Condylar hypermobility in the position of maximally open mouth leads to the subluxation of the joint, and the two terms can thus be considered synonyms. The predisposition of the morphological relations of the zenith of the articular eminence and the contours of the articular surfaces lead to an excessive anterior displacement of the condyle over the zenith eminence. In addition, the irregular movement of the disc-condylar complex can also occur. The aim of this paper is to explain the hyperextension of TMJ which may, along with anatomical predisposition to the maximally open mouth position, lead to subluxation or luxation of the joint. Subluxation is not associated with a specific pathological characteristic of the joint. However, apart from discomfort, a subluxation can also cause pain. The excursory movement of the condyle close to and over the individual opening limit can lead to stiffness of joints and the inability to open the mouth (open lock), which is a prominent clinical sign of TMJ luxation. Electronic axiography can show pathological hyperextension of the condyle, while x-ray diagnostics records the condition of subluxation. A spontaneous luxation is clinically evident and therefore radiological diagnosis is used only to confirm the condition. Magnetic resonance imaging shows the disc and in the position of the maximally open mouth, thus giving the responses of the disk relation to the hypermobile condyle. Therapeutic modalities include occlusal splints and oral appliances, physiotherapy, and the mouth opening self-control. The goal of the treatment is relaxation of the masticatory muscles, removal of pain in the joint and muscles, and better coordination of movement, particularly in cases when there is a predisposition of spontaneous luxation.
Current Concepts About Temporomandibular joint disorders: A Review Article
Journal of Research in Medical and Dental Science, 2020
Temporomandibular joint is formed by the mandibular condyle inserting into the mandibular fossa of temporal bone. It’s considered as ginglymoarthroidal joint which mean that is capable of both hinge type and gliding movements. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age. However, it can be classified as intra-articular or extra- articular. The incidence varies from 21.5% to 50.5%. The prevalence of TMD is about 3.7-12% greater in women than men. There are two types of treatment: conservative and surgical. We all believe that the valid diagnosis is the key to successful treatment on account of TMD multifactorial nature and often of patients suffering from other disorder simultaneously that can make the correct diagnosis difficult. Manual TMJ inspection was and remain self-evident manner used to detect joint dysfunction related to clinical findings. The primary study should be plain radiography (transcranial, trans maxillary views) or panoramic radi...
Temporomandibular joint disorders – a lookback in time
International Journal of Dental Research, 2017
The variety of terms used has contributed to a great amount of confusion that exists in this already complicated field of study. Lack of communication and coordination of research efforts often begins with differences in terminology. Therefore in an attempt to coordinate efforts, the American Dental Association began to use TMD to include all functional disturbances of the masticatory system. The article reviews the research work done by various authors pertaining to the disorders of the temporomandibular joint.
Journal of Oral Rehabilitation, 2013
To describe the scientific literature about the diagnosis, prevalence, aetiology, natural course and possible treatment modalities of disc displacements within the temporomandibular (TM) joint. PubMed was searched for specific indexing terms. The search yielded 1211 papers. After screening according to title and abstract, 695 papers were excluded, and after full-text reading, 107 papers remained. Hand-searching of the reference lists resulted in an extra 47 papers. Thirteen studies, published since the literature search was carried out, were also included, resulting in 167 papers for this review. A disc displacement is a highly prevalent derangement within the TM joint, with reported prevalence ranging from 18% to 35% in the general population. A disc displacement with reduction is mostly a stable, pain-free and lifelong condition of the joint. In only a small minority of patients, the disc loses its capacity to reduce on opening. Surprisingly, only in rare cases, the loss of disc reduction is accompanied by signs and symptoms of a closed lock (viz. a painful and limited mouth opening). These signs and symptoms have a tendency to reduce and in many cases to resolve within months. The favourable natural course of disc displacements only warrants active treatment for symptomatic disc displacements without reduction. The primary treatment option is a conservative, non-surgical treatment focusing at speeding up the natural process of alleviation of pain and of improvement in mouth opening. For most patients, a disc displacement is just a painfree, lifelong lasting, 'noisy annoyance' from their TM joint.
Evaluation of Clinical Features in Patients with Temporomandibular Joint Disorders Research Article
SciDoc Publishers, 2021
Objective: Temporomandibular joint disorder [TMD] is a muscular and articular disorder. There are various clinical features associated with TMD. These include clicking sound, deviation of jaw, pain on palpation, and limited mouth opening. The aim of the study was to assess the various clinical features occurring predominantly in patients with temporomandibular joint disorders in our regional population. Methods: In this retrospective study, a total of 192 patients who had temporomandibular disorders were included. The following parameters were evaluated based on the dental records; age, gender, types of TMD and clinical manifestations of TMD. Excel tabulation and SPSS version 23 was used for data analysis and results obtained. Results: The age group most affected with TMD was 21-30 years with a predilection for males. Disc- condyle disorders was the predominant type of TMD [especially in the younger population] followed by MPDS and degenerative disorders in the study population.Clicking and pain on palpation were the most predominant clinical features of TMD followed by a combination of pain, clicking and deviation of the jaws. Least prevalent findings were limited mouth opening and a combination of pain on palpation and the deviation of the jaws.Pain on palpation among elderly people and clicking and a combination of pain, clicking and deviation of the jaws among younger people were found to be the predominant signs and symptoms of TMD. Pain on palpation was present predominantly in male participants and clicking was seen predominantly in female participants. Pain on palpation was the predominant finding in degenerative disorders. Pain on palpation followed by limited mouth opening were the predominant findings in MPDS. Clicking sound followed by a combination of pain, clicking and deviation of the jaws were the predominant features in disc condyle disorders. The association between age, gender and the types of TMD was statistically significant. Also, the association between the age, gender, types of TMD with the clinical features of TMD was also statistically significant.