Structural and Functional Disorders of the Temporomandibular Joint (Internal Disorders)

Abstract

There are many factors that can cause damage to the temporomandibular joint (TMJ) structures or impair normal functional relationships between condyle, disc and eminence. The main symptoms associated with TMJ dysfunction are pain, limited mobility of the mandible, spasticity of the masticatory muscles and sound that is produced in the joint during mandibular movement. Pain originates from nociceptors located in soft tissue of the joint. If the soft tissue structures are not in inflammation, the pain is sharp, sudden and intense tightly connected to the movements in the TMJ. If the inflammation is presented, the pain is constant and increases with the movements in the joint. TMJ dysfunction is manifested by feeling stiffness of the joint, limited and/or altered opening of the mouth with deviation or deflection of the mandible. Individual or multiple sound produced by the TMJ are most often the consequence of the disturbed function of the condyle-disc complex, the morphological incompatibility of the joint surfaces or degenerative changes in them. The signs and symptoms of disease and dysfunction of TMJ are different and depend on the duration of the disorders and its chronicity as well as on the individual sensitivity of the patients. Proper identification of symptoms and precise diagnosis are therefore essential for future treatment.

Evaluation of temporomandibular joint changes seen in pre-operative and post-operative patients of oral submucous fibrosis using MRI: A prospective study

“…The constant excessive pressure in that zone can lead to perforation of the disc. 8 Trismus is one of the classical manifestations of OSMF due to accumulation of inelastic fibrous tissue in the juxta epithelial region of oral mucosa with associated muscle degeneration. Progressive restriction in movement of the joint secondary to OSMF and a deficient functional stimulation of TMJ leads to reduced efficiency of the temporomandibular joint.…”

“…According to another study, it has been observed that there are bony changes in terms of generalised osteoporosis of cancellous and cortical bone due to prolonged immobilisation of rat knee joints. 8,15 Some investigators evaluated changes in TMJ anatomy through MRI in patients with disc displacement and found a substantive change and a direct correlation. 16 A definite correlation to structural changes with duration of reduced mouth opening was noted in all the cases but statistically significant results were not obtained due to small sample size.…”

Biological Treatments for Temporomandibular Joint Disc Disorders: Strategies in Tissue Engineering

“…In conditions of closed-mouth position and teeth contact, if there is an extreme and long load, it could cause the thinning of the disc in the central band [59]. Moreover, cases of displacement could also lead to thinning of the posterior band [60].…”