TMJpathologie

TMJpathologie refers to diseases and disorders affecting the temporomandibular joint (TMJ) and surrounding structures. The TMJ connects the mandible to the temporal bone and supports jaw movement. Pathologies fall under the umbrella of temporomandibular disorders (TMD) and may involve mechanical, inflammatory, degenerative, or systemic processes that impair function and cause pain.

Common conditions include disc displacement with or without reduction, myofascial and joint pain (arthralgia), capsulitis, synovitis, osteoarthritis, and inflammatory arthritides such as rheumatoid arthritis. Less frequent problems include ankylosis, condylar resorption or hyperplasia, and post-traumatic or post-surgical complications.

Etiology is multifactorial, involving mechanical overload, occlusal factors, parafunctional habits (eg, bruxism), trauma, and systemic diseases. Psychological factors and psychosocial stress can modulate pain perception and treatment response. The clinical presentation ranges from intermittent jaw pain and joint noise to limited mouth opening and functional impairment.

Diagnosis relies on history and examination: tenderness, range of motion, jaw deviation, and joint sounds. Imaging includes MRI for disc and soft tissue evaluation, CT or CBCT for bony changes, and ultrasound in some settings. Laboratory tests are reserved for suspected inflammatory arthritis.

Treatment is typically conservative, including patient education, soft diet, heat or cold application, physical therapy, occlusal splints, NSAIDs, and muscle relaxants. Intra-articular injections (corticosteroids, hyaluronic acid) may be considered. Refractory cases may require arthrocentesis or arthroscopy; severe degenerative disease or ankylosis may necessitate open surgery or joint replacement.

Prognosis varies with underlying pathology; many cases respond to conservative care. TMJ pathology is more common in adults, with a female predominance.