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Surgical Procedures & TMJ Care

Distraction Osteogenesis

Comprehensive clinical guide to Temporomandibular Joint (TMJ) disorders, jaw symptoms, surgical management, and corrective jaw procedures by specialized Maxillofacial Surgeons.

TMJ Evaluation
Symptom & Joint Diagnosis
Pain Relief
Spasm & Inflammation Care
Splint Therapy
Nightguards & Orthotics
Osteogenesis
Corrective Jaw Surgery
Clinical Presentation

What are common TMJ Symptoms?

3D TMJ Dynamics
Joint Biomechanics

TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. TMJ pain disorders usually occur because of unbalanced activity, spasm, or overuse of the jaw muscles. The following are common symptoms.

  • bullet Headache: which is often made worse while opening and closing the jaw. Exposure to cold weather or air-conditioned air may increase muscle contraction and facial pain.
  • bullet Ear pain: Ear pain and do not have signs of ear infection. The ear pain is usually described as being in front of or below the ear.
  • bullet Sounds: Grinding, crunching, or popping sounds, medically termed crepitus, are common for patients with a TMJ disorder. These sounds may or may not be accompanied by pain.
  • bullet Ringing in the ear (tinnitus): For unknown reasons, 33% of patients with a TMJ disorder experience noise or ringing in the ears (tinnitus). Of those patients, half will have resolution of their tinnitus after successful treatment of their TMJ disorder.

These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. It is important to note that joint noise is not always indicative of a TMJ disorder and quite frequently requires no treatment at all.

Joint Mechanics

Trouble with your Jaw?

Clinical Examination of the Jaw

TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your jaw joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking or grating noise when you open your mouth or trouble opening your mouth wide.

Patient Self-Assessment

Do you have a TMJ Disorder?

  • bullet Are you aware of grinding or clenching your teeth?
  • bullet Do you wake up with sore, stiff muscles around your jaws?
  • bullet Do you have frequent headaches or neck aches?
  • bullet Does the pain get worse when you clench your teeth?
  • bullet Does stress make your clenching and pain worse?
  • bullet Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • bullet Is it difficult or painful to open your mouth, eat or yawn?
  • bullet Have you ever injured your neck, head or jaws?
  • bullet Have you had problems (such as arthritis) with other joints?
  • bullet Do you have teeth that no longer touch when you bite?
  • bullet Do your teeth meet differently from time to time?
  • bullet Is it hard to use your front teeth to bite or tear food?
  • bullet Are your teeth sensitive, loose, broken or worn?
Anatomical Structure of TMJ
Clinical Protocol

Treatment

TMJ Arthrocentesis & Joint Therapy

The initial goals are to relieve the muscle spasm and joint pain. This is usually accomplished with a pain reliever, anti-inflammatory, or muscle relaxant. Steroids can be injected directly into the joints to reduce pain and inflammation.

Patient Care

Self-care Treatments

Jaw Physiotherapy & Exercises

Self-care treatments can often be effective and include:

  • bullet Resting your jaw
  • bullet Keeping your teeth apart when you are not swallowing or eating
  • bullet Eating soft foods
  • bullet Applying ice and heat
  • bullet Exercising your jaw
  • bullet Practicing good posture
Orthotic Appliances

Stress Management & Splint Therapy

Stress management techniques such as biofeedback or physical therapy may also be recommended, as well as a temporary, clear plastic appliance known as a splint. A splint (or nightguard) fits over your top or bottom teeth and helps keep your teeth apart, thereby relaxing the muscles and reducing pain. There are different types of appliances used for different purposes. A nightguard helps you stop clenching or grinding your teeth and reduces muscle tension at night and helps to protect the cartilage and joint surfaces. An anterior positioning appliance moves your jaw forward, relieves pressure on parts of your jaw and aids in disk repositioning. It may be worn 24 hours/day to help your jaw heal. An orthodontic stabilization appliance is worn 24 hours/day or just at night to move your jaw into proper position. Appliances also help to protect from tooth wear.