TemporomandibulargelenkErkrankungen

The temporomandibular joint (TMJ) is the articulation between the mandible and the temporal bone of the skull. It is a complex, synovial joint that includes an articular disc, a fibrous capsule, and supporting ligaments. The disc divides the joint into superior and inferior compartments and helps coordinate movement between the jawbones during opening, closing, and chewing.

The TMJ enables hinge movements for chewing and speaking and gliding motions for wide opening and lateral (side-to-side) movement. Muscles of mastication, including the masseter, temporalis, and pterygoids, act on the joint to produce these motions, while the articular disc and capsule help stabilize the joint and absorb forces.

Temporomandibular disorders (TMD) refer to problems affecting the TMJ and surrounding muscles. Common symptoms include jaw pain or tenderness, limited or irregular jaw opening, jaw locking, and noises such as clicking or crepitus. Causes are multifactorial and may include jaw injury, bruxism or teeth grinding, arthritis, malocclusion, stress, and overuse of the jaw.

Diagnosis involves clinical examination, assessment of range of motion and bite, and imaging such as MRI for soft tissues and CT for bone. The differential diagnosis includes dental problems, ear disorders, and other facial pain conditions.

Treatment is typically conservative and personalized. Many cases improve with education, soft diets, warm applications, physical therapy, jaw exercises, NSAIDs, and muscle relaxants. Occlusal splints or bite guards can help some patients. In refractory cases, injections (corticosteroids or hyaluronic acid), arthrocentesis, arthroscopy, or, rarely, open joint surgery may be considered. Prognosis varies; many patients improve with treatment, though some experience persistent symptoms. TMD is more common in women and often begins in adolescence or early adulthood.