Jaw joint pain TMJ (Temporomandibular Joint)

Do you wake up in the morning with pain in your jaw area? Do you have problems when opening your mouth and pain when chewing? Does your jaw sometimes freeze? Do you clench or grind your teeth? Many people suffer from pain and disorders in the area of the chewing muscles, the head and throat muscles as well as the jaw joint. This problem, known as craniomandibular dysfunction, has a wide clinical presentation and can be treated individually using a variety of techniques.

Symptoms

  • Pain in the region of the jaw joints (jaw angle, spreading to the lower jaw, temples, ear, possibly also headaches),
  • pain in the region of the chewing muscles (cheeks, temples), above all when chewing.
  • Limited ability to open the mouth.
  • The jaw gets stuck when opening or closing the mouth.
  • Noises when opening the mouth (cracking, rubbing).
  • The mobility of the jaw is limited.
  • The joints are “drooping”.
  • Disorders of the bite.
  • Headaches
  • Rarer: earache, tinnitus.

Diseases of the jaw joint

Craniomandibular dysfunction (CMD) is a general term for various pathologies and problems of the jaw muscles and joints. 

1. Disorders due to overloading, which affect above all the muscles and ligaments 

2. Disorders or degenerative symptoms which affect the jaw joint directly (condylar head and socket etc.) such as osteoarthritis, arthritis, chondromatosis etc.

3. Pathologies which affect the cartilage lying between the head and socket (e.g. discus dislocation or discus perforation) 

4. Growth disorders of the jaw joint such as condylo-mandibular elongation and hyperplasia cause extreme lower jaw asymmetries and deformations. Correcting these asymmetries requires great experience.

5. Ankylosis of the jaw joints: In this case, a fibrous or osseous connection between the socket and the mandibular condyle exists. Professor Sailer cures ankylosis using different techniques according to the pathological situation and deploying lyophilised cartilage slides, sheets or also by completely replacing the joint (endoprosthesis).

6. Jaw joint disorders in the case of systemic diseases such as polyarthritis, morbus bechterew, scleroderma etc. Thanks to Professor Sailer’s decades of experience in the complex jaw joint problems of systemic diseases, an improvement of the chewing and joint function is always achieved.

7. Tumours and tumour-like changes of the jaw joint:

a) Chondromatosis Formation of numerous cartilage-like, partly free moving joint corpuscles which limit the mobility of the joint and can be painful. These can be surgically removed.

b) Exostoses, i.e. osseous growths on the mandibular condyle which cause deformations and asymmetries of the lower jaw and luxation of the condyle.

c) Tumours and metastases caused by breast or prostate cancer, for example, must always be taken into consideration during diagnosis. The surgical removal of the condyle then becomes necessary with simultaneous reconstruction using artificial joints or lyophilised jaw parts (see Professor Sailer’s bibliography).

 

 

 

Growth disorder of jaw joints
after treatment

Treatment methods

The most important step towards the treatment of craniomandibular complaints is careful examination and diagnosis (examination, imaging procedures, arthroscopy) in order to recognise exactly the cause of the problem. Independent of this, there are many non-operative and operative treatment methods. The therapy plan must be adjusted to suit each individual patient (life circumstances, possibilities to get involved actively himself/herself) and of course the disorder itself.

Conservative treatment methods include physiotherapeutic treatment, neuromuscular stimulation therapy, diverse biofeedback techniques and even an accompanying treatment with medication. Often a change in lifestyle is a simple method to achieve rapid improvement. There are also various splints (known as bite trays) which can represent a good treatment option.

Furthermore there are minimally invasive techniques such as injections or rinses in the jaw joint area to halt the progress of the inflammation and to promote regeneration in the joint area. Additionally, various medicines and regenerative substances can be directly instilled into the joint, so that they can take effect.

If there are no other treatment possibilities, then the jaw or the associated structures can also be treated surgically. In this case, the joint is exposed and treated when directly visible. In the case of this operation the cuts are made right next to the ear, so that after the healing process is complete, no scarring is visible.

A common syndrome within the context of craniomandibular dysfunction is the relocation of the discus (cartilage) in front of the condylar head. There is often a clicking in the joint as well as pain, caused by malposition of the discus in front of in the condylar head. Treatment can prevent the advancement of the condition.