dental disorders
Arthritis of the Temporomandibular Joint (TMJ)
Secondary degenerative arthritis
This arthritis usually develops in people (usually women) aged 20 to 40 years with a history of trauma or persistent temporomandibular Temporomandibular Myofascial Pain Syndrome . It is characterized by limited opening of the mouth, unilateral pain during jaw movement, joint tenderness, and crepitus. When it is associated with temporomandibular myofascial pain syndrome, symptoms wax and wane. Unilateral joint involvement helps distinguish secondary degenerative arthritis from osteoarthritis. Diagnosis is based on x-rays, which, as in Osteoarthritis (OA) , generally show condylar flattening, lipping, spurring, or erosion. Treatment is conservative, as it is for temporomandibular myofascial pain syndrome, although arthroplasty or high condylectomy may be necessary. An oral appliance (occlusal splint [mouth guard]) usually relieves symptoms. The appliance is worn constantly, except during meals, oral hygiene, and appliance cleaning. When symptoms resolve, the length of time that the appliance is worn each day is gradually reduced. Intra-articular injection of corticosteroids may relieve symptoms but may harm the joint if repeated often. 