Treatment of Temporomandibular Disorders (TMD) Page 2

TMJ Arthritis

The TMJ is suseptible to arthritis as are most joints in the body. There are two common forms of arthritis that affect this joint. A description of each is given below.

Degenerative Arthritis (Osteoarthritis)

Degenerative arthritis is the most common athritic disorder of the TMJ. It is usually characterized by grating or grinding noises in the joint and is usually painful only during heavy-duty chewing or clenching. It is caused by trauma to the joint, prolonged clenching or grinding disorder, perforation of the disc or as a natural result of aging.

Abnormal TMJ, Advanced generative arthritis. 32K jpeg) Note how broad and flat the top of the condyle appears. The disc is destroyed and only a remnant remains in front of the condyle.

MRI of degenerative arthritis. (7K jpeg) The condyle (red arrow) takes on a classic "Bird beak" appearance.

MRI of severe degenerative arthritis. (7K jpeg) In this more severe case of degenerative arthritis the top of the condyle has been completely destroyed (red arrow). The disc (green arrow) has been displaced anteriorly.

Rheumatoid Arthritis

Rheumatoid arthritis is a systemic disease which means it can affect any joint in the body. It is thought to be an autoimmune response to the synovial tissues of the joint. In other words, the body thinks the joint is a foreign substance and attacks it, causing severe pain and destruction of the joint. Most people with rheumatoid arthritis of the TMJ also have the disease in other joints of the body (but not always).

MRI of Rheumatoid arthritis. (7K jpeg) This is a typical MRI of Rheumatoid arthritis. The top of the condyle is ragged (red arrow) and the disc is displaced forward. Frequently the fossa also appears enlarged.

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