Posttraumatic Temporomandibular Joint Disorders

Abstract

The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ.

Osteoarthritis of the temporo-mandibular joint in free-living Soay sheep on St Kilda

“…OA of the TMJ in humans is usually caused by wear and tear leading to osteophytosis (Matsuura et al, 2001;Giannakopoulos et al, 2009). In humans, degenerative OA is an agerelated disease with the severity of osseous changes in the condylar head and mandibular fossa increasing with age (Alexiou et al, 2009).…”

Temporomandibular Joint Disorders in Children and Related Comorbidities

“…Direct trauma to the mandible producing condylar fractures, sub condylar fractures, other mandibular fractures, or no fractures has been implicated as one of the initiating factors of osteoarthritis. Trauma to the mandible can induce a joint effusion acutely [31,32]. Harris et al studied 13 patients who had sustained trauma to the mandible and found abnormal uptake in their TMJ scintiscans [33].…”

“…Also, Seligman and Pullinger showed in a multiple stepwise logistic regression analysis that trauma history is a moderate differentiating feature in patients with intracapsular TMJ disorder [35]. Due to the complex and multifactorial etiology of this particular disease process, the actual incidence of osteoarthritis directly related to trauma to the mandible is difficult to determine, especially in traumatic events that do not result in fractures [31]. The existing literature reports a wide range.…”

“…The predominant symptoms include constant preauricular pain, with or without radiation, and crepitus. Other symptoms and signs are TMJ clicking, popping, locking, and deviation on opening [31,37].…”

“…Also, the chin will deviate toward the affected side. Furthermore, dental compensations, crossbites on the ipsilateral side and hypereruption of the teeth on the contralateral side, producing an occlusal can't, will eventually occur to re-establish a functional occlusion [31].…”