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  • Temporomandibular joint dysfunction (TMJD)
  • Temporomandibular joint pain
  • Temporomandibular joint internal derangement
  • Temporomandibular joint dysfunction syndrome
  • Costen’s syndrome

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  • 524.6 Temporomandibular joint disorders
  • 524.60 Temporomandibular joint disorders, unspecified
  • 524.61 Temporomandibular joint disorders, adhesions and ankylosis (bony or fibrous)
  • 524.62 Temporomandibular joint disorders, arthralgia of temporomandibular joint
  • 524.63 Temporomandibular joint disorders, articular disk disorder (reducing or non-reducing)
  • 524.64 Temporomandibular joint disorders, temporomandibular joint sounds on opening and/or closing the jaw
  • 524.69 Other specified temporomandibular joint disorders

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  • M26.60 Temporomandibular joint disorder, unspecified
  • M26.61 Adhesions and ankylosis of temporomandibular joint
  • M26.62 Arthralgia of temporomandibular joint
  • M26.63 Articular disk disorder of temporomandibular joint
  • M26.69 Other specified disorders of temporomandibular joint

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Description

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  • Often referred to as TMJ (temporomandibular joint) which is the name of the joint, but does not describe any specific dysfunction
  • Syndrome is an umbrella term describing acute or chronic inflammation of the TMJ.
  • Diagnosis covers an array or acute or chronic problems of the TMJ.
  • Originally described by James B. Costen in 1934 and initially known as Costen’s syndrome.
  • Five stages of disk displacement

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Essentials of Diagnosis

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  • Dysfunction of the joint, muscle imbalances
  • Alignment problems between the temporal and mandible bones and the cervical spine

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General Considerations

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  • The TMJ has two joints, allowing one to rotate and slide (translate).
  • Ligament laxity and disk desiccation need to be assessed.
  • Wear of the bone and cartilage can lead to popping, clicking and pain.

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Demographics

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  • Women > men
  • Age range: 20 to 40 years of age

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Signs and Symptoms

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  • Can involve one or more of the TMJ components such as the muscles, nerves, tendons, ligaments, bones, and teeth
  • Deviation of the mandible with opening and closing
  • Malalignment of the teeth
  • Wearing of the teeth, flattening of the top of the teeth
  • Grinding
  • Hypertonicity of the pterygoids and masseter muscles
  • Ear pain, ache (otalgia) and ear swelling
  • Orofascial pain
  • Audible click/pop with opening and closing of the jaw
  • Reciprocal clip
  • Limited opening of the jaw
  • Inability to open/close jaw/locking
  • Crepitus
  • Swelling, heat, redness at the TMJ
  • Headaches/migraines
  • Tinnitus
  • Trigeminal nerve issues, Cranial nerve (CN) V

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Functional Implications

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  • Inability to bite/eat larger objects such as an apple
  • Headaches that limit function
  • Locking of the jaw

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Possible Contributing Causes

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  • Trauma
  • Whiplash
  • Blunt trauma, punch or hit to the face increased lateral movement of the mandible
  • Muscle imbalances head, neck
  • Malalignment, from bridge, overlay, or crown that alters bite and pressures
  • Jaw thrusting from tongue and speech problems
  • Previous orthodontic work, wisdom teeth extraction
  • Excessive gum chewing ...

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