Temporomandibular joint pain

Many people do not have much understanding of joint pain because they do not have the disease themselves and do not know what symptoms will occur. The causes and manifestations are also different. There are many types of joint pain, such as temporomandibular joint pain, which mainly comes from psychological factors. Because of mental tension and excessive anxiety, the pain will be aggravated. In addition, it is not ruled out that it is due to immunity, functional problems of teeth, and excessive joint overload.

reason

It is generally believed to be related to the following factors:

1. Psychosocial factors: Patients often have mental symptoms such as anxiety, irritability, mental tension, excitability and insomnia. Some patients can clearly have a causal relationship between mental and emotional factors and the onset of the disease. In chronic and protracted patients, the influence of mental factors on the recurrence of symptoms can also be found.

2. Occlusal factors: Clinical examination of TMD patients often reveals obvious occlusal factors, including interference, premature cusp contact, severe lockbite, deep overbite, majority of posterior teeth missing, and excessive wear of the occlusal surfaces resulting in a low vertical distance.

3. Immune factors: Immunological studies have shown that the main components of articular cartilage, such as collagen polysaccharides and chondrocytes, are antigenic. Because articular cartilage is wrapped in matrix, it is isolated from the vascular system from embryo to adult, becoming a closed antigen that cannot be recognized by the body's immune system. Related experimental studies have shown that TMD also involves cellular immunity.

4. Excessive load on joints: Moderate weight-bearing is necessary and important for maintaining the normal structure, function and physiological remodeling of joints. However, excessive weight bearing beyond physiological limits can cause degenerative changes or even damage to the joints.

5. Joint anatomical factors: From a functional point of view, the temporomandibular joint and jaw have become more flexible as humans evolve to adapt to more complex jaw movements for speech and facial expressions. Because of this, from an anatomical point of view, the corresponding joints, muscles and ligaments become significantly weakened, and the load-bearing capacity of the joints decreases. This increase in the type, flexibility, and range of joint motion in humans is a potential threat to the anatomically weakened temporomandibular joint.

6. Other factors: Cold stimulation of the joint area, muscle dysfunction caused by bad posture and affecting the normal position of the mandible and condyle are also factors that induce temporomandibular joint disorder.

examine

Patients often experience chronic pain in the unilateral or bilateral temporomandibular joints. The pain may radiate behind the ears, limit mouth opening, and cause local traction pain. There is often a crisp sound when the temporomandibular joint moves, and the pain is often aggravated by chewing hard objects, yawning, and cold.

Auxiliary examination:

① Plain X-ray films (Schuhler view and transpharyngeal lateral condylar film) can reveal changes in the joint space and bone quality, such as sclerosis, bone destruction and hyperplasia, and cystic changes.

②Arthrography and magnetic resonance imaging can reveal articular disc displacement, perforation, and changes in articular disc attachments.

③Arthroendoscopic examination can reveal early changes of the disease.