Rehabilitation treatment of temporomandibular joint disorder syndrome

Temporomandibular joint disorder syndrome is the most common disease of the oral and maxillofacial region, and the pathogenesis is not fully understood. The main clinical manifestations of this disease are a pain in the joint area, joint snapping during exercise, and mandibular movement disorder. Most of them are joint dysfunction and have a good prognosis; however, qualitative changes can also occur in very few cases.

 

temporomandibular joint disorder syndrome

 

Cause

01// Mental factor

Mental factors play a very important role in the occurrence and aggravation of temporomandibular joint disorder syndrome.

 

02// Trauma factor

Many patients have a history of local trauma. Such as acute trauma such as being hit by an external force, biting hard objects suddenly, opening your mouth too large (such as yawning), often chewing hard food, grinding teeth at night, and unilateral chewing habits. These factors may cause joint contusion or strain, and masticatory muscle dysfunction.

 

03// Occlusal factor

Occlusal disorders can also lead to the development or aggravation of temporomandibular joint disorder syndrome. Such as occlusal interference, excessive tooth wear, too many missing molars, poor restorations, too low intermaxillary distance, etc. The disorder of the occlusal relationship can destroy the balance of functions between the internal structures of the joints, and promote the occurrence of this disease.

 

04// Systemic and other factors

Systemic diseases, such as rheumatoid arthritis, can also cause TMJ disorders. In addition, some iatrogenic factors, such as radiation therapy for nasopharyngeal carcinoma, can lead to structural and functional changes in the masticatory muscles and can also cause temporomandibular joint disorder syndrome.

 

temporomandibular joint disorder syndrome

 

Clinical Manifestations

The main clinical manifestations of temporomandibular joint disorder syndrome are local joint soreness or pain, joint snapping, and mandibular movement disorder. The pain site may be in the joint area or around the joint and may be accompanied by tenderness ranging from mild to severe. Joint soreness or pain, especially when chewing and opening the mouth. The snapping sound occurs when the mouth is opened. The rattling can occur at different stages of jaw movement and can be a crisp single click or a shattering streak. Common movement obstacles are limited mouth opening, mandibular deviation during mouth opening, and limited left and right mandibular movement. In addition, it may be accompanied by symptoms such as temporal pain, dizziness, and tinnitus.

 

Treatment

Medical treatment

Drug therapy is a common treatment for temporomandibular disorder syndrome, which can effectively relieve symptoms. Commonly used drugs include analgesics, anti-inflammatory drugs, corticosteroids, anti-anxiety drugs, muscle relaxants, tricyclic antidepressants, Chinese medicine, etc.

Analgesics can reduce pain in patients and can also reduce secondary inflammatory diseases caused by pain, such as radiating pain caused by muscle contractions. Non-opioid analgesics are effective for mild to moderate pain caused by acute temporomandibular disorder syndrome, and opioids are only used for short-term use in severe acute pain. Nonsteroidal anti-inflammatory drugs have analgesic and anti-inflammatory effects and are used for TMJ pain caused by inflammatory processes, but caution should be exercised in patients with gastrointestinal irritation and anxiety.

 

non-drug treatment

(1) First of all, the influence of mental factors should be removed, and if necessary, a psychiatrist should assist in formulating a treatment plan and conduct psycho-behavioral therapy;

(2) Correct the occlusal relationship and bad habits, such as excessive mouth opening, unilateral chewing, etc.;

(3) Other non-drug treatments, such as nerve stimulation therapy, nerve block therapy, surgical treatment, physical therapy, traditional Chinese medicine acupuncture therapy, etc.

 

physiotherapy

Physiotherapy is an important method for the treatment of temporomandibular joint disorder syndrome. Commonly used physiotherapy methods include ultrashort wave therapy, ultrasonic therapy, infrared therapy, magnetic therapy, direct current iontophoresis, and so on.

 

The ultrashort wave or short wave: use low-power therapeutic apparatus, the opposite or oblique method of the temporomandibular joint on the affected side, and micro heat;

Infrared light: use infrared polarized light to irradiate the affected part vertically, at a distance of 20-30cm, for 20 minutes;

 

Magnetic therapy: Magnetic therapy has a good antispasmodic effect, which can relax the masticatory muscles of patients, relieve pain and functional limitation, and can also improve local blood circulation, and play an anti-inflammatory and analgesic role, which is conducive to the recovery of patients.

 

Intermediate frequency electricity: Intermediate frequency electricity can speed up tissue blood circulation and metabolism, increase the excitability of sensory and motor nerves, improve local pain threshold, have an analgesic effect, can also dissipate edema, promote the discharge of pain-causing substances and inflammatory products, and release The effect of adhesion and softening of tissues can relieve pain, reduce inflammation, relieve muscle spasm and improve myofascial tension, which is conducive to the recovery of muscle function.

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