What are 
Temporomandibular joint
 ?

Temporomandibular joint (TMJ) is a very unique joint unlike any other joint of the human body. It is a complex joint which comprise of bones, disc, ligaments and muscles. This joint functions as a result of well-balanced interplay between the teeth, the jaws, and the muscles. Also due to the proximity of the joint with various other nerves, it is very common to see the pain of the TMJ getting referred to head and neck region. It is very common to encounter patients with unexplained headache or earache or neck pain which turns out to be related to TMJ issues. Because of the complexity of the structure and its functions, a whole new sub-speciality has come up where the Dentists or the Maxillofacial Surgeons acquire specialised training in handling such patients.

TMJ disorders related to the disc is referred to as the TMJ Internal Derangement and is the most frequently encountered problem affecting the joint. It can range from a simple clicking sound of the joint on opening or closing to severely restricted painful joint in the extreme cases. If the clicking or the popping sound is not associated with any reduction in mouth opening or any pain, then rarely any treatment is indicated. However, if the patient encounters any pain or has any functional limitation of the joint, it is advisable to seek the treatment at the earliest. If left ignored, this process keeps on worsening and can become catastrophic.
Diagnosis of 
TMJ
 disorder
Diagnosis of such problems is mostly made by clinical examination by a TMJ specialist and is augmented by x-rays, CT or MRI scans as and when deemed necessary. Treatment of such issues are based on the degree of damage that the joint has suffered. In its initial stages, conservative management by life style modifications along with short term medications are generally enough. In certain patients, where the joint problem is related to the parafunctional or abnormal functioning of the teeth, it might be necessary to carry out some dental treatment to correct the occlusion or it might be corrected by certain appliances fabricated to relieve the stress on the joint.
Image showing TMJ and ear canal
TMJ 
disorder
 management
In moderately severe cases, the next modality is the surgical treatment. Surgical treatment also ranges from minimally invasive procedures like TMJ arthrocentesis or TMJ Arthroscopy. We boast the facility of carrying out these minimally operative joint procedures as we have become the 1st centre in Central India to acquire a TMJ Arthroscope.
temporomandibular joint- equipment to do the TMJ surgery
In more severe cases, correcting the joint problems may not be amenable to minimally invasive procedures and require an open joint surgery. However, in non-salvagable joints, the final treatment option is to carry out TMJ replacement with an artificial joint. Even though, certain functions might get limited by these prosthetic joints, the patient still achieves reasonable mouth opening and painless chewing efficiency which ultimately improves the patient’s quality of life!

Hence, we can see that a simple Temporomandibular joint, even though so small in size can be cause of great concern to the patient if the correct and appropriate treatment is not carried out in time!

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Medical Doctor
Dr. Anurag Bhargava

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