TMJ Trauma

TMJ Trauma

TMJ pain can be caused by trauma, disease, wear and tear due to aging or faulty habits. Pain due to trauma to the TMJ can be caused by internal or external factors.

Internal factors

  • Teeth clenching (jaw tightening)
  • Bruxism (grinding of teeth during sleep)
  • Malocclusion/ malaligned teeth

 

External factors

A punch to the jaw or injury caused by a road traffic accident can break the jaw bones and cause temporomandibular joint to dislocate. This can severely damage the disc of the joint which will exude severe pain and functional disability to the patient. The severity of the fracture/dislocation will determine the line of treatment. Bilateral fractures of the condyle head without displacement of the fractured bone segments will require immobilization of the jaws.

Diaplaced bone segments of the lower jaw pertaining to the TMJ will require open reduction and stabilization.

Case 1

A software professional reported to Balaji Dental and Craniofacial Hospital a few days after he met with an accident. He said to have had a trauma to the right side of his face. He had difficulty in opening his mouth wide and he suffered pain in his right jaw joint while opening and closing his mouth. He also had severe pain in his right jaw joint while clenching his teeth. A digital X-ray revealed a fracture of the right condyle (the part of the lower jaw that forms a component of the jaw joint or Temporomandibular Joint/TMJ).

Eminent Oral & Maxillofacial Surgeon Dr. S.M. Balaji is accomplished in jaw joint fracture surgeries and has to his credit exemplary success in TMJ, facial and jaw bone fracture treatments. The fractured bone segment was surgically exposed and stabilized in an accurate position using bone plate.

Following surgery, the wound healed well. Postoperative X-ray showed good bone healing. The patient had no pain during his jaw movements and his mouth opening improved considerably. The surgical scar is negligible and barely noticeable.

Immediately after trauma - inability to open the mouth normally

Immediately after trauma - inability to open the mouth normally

X-ray showing fractured right condyle

X-ray showing fractured right condyle

During surgery-bone plate placed to stabilize condyle fracture

During surgery-bone plate placed to stabilize condyle fracture

Right condyle fracture stabilized using bone plate

Right condyle fracture stabilized using bone plate

Improved mouth opening following surgery

Improved mouth opening following surgery

Post operative X-ray showing good healing of the fractured bone segments

Post operative X-ray showing good healing of the fractured bone segments

Barely visible scar and good healing following surgery

Barely visible scar and good healing following surgery

Case 2

A 6-year-old boy reported to Balaji Dental & Craniofacial Hospital with his parents who said that over the past few months, the boy was finding it increasingly difficult to open his mouth. The face particularly chin began to appear crooked. The parents also said that some time ago, the boy had suffered a fall and had injured the right side of his face.

A CT scan revealed ankylosis of his right temporomandibular joint. Instead of a normal joint space, the right condyle head had fused and there was a bony mass instead, which prevented normal growth of the mandible (lower jaw). A surgical procedure called gap arthroplasty with costchondral grafting was performed. The fused bony mass was removed and the joint movement was re-established. A bone graft from the child’s rib was taken and the right temporomandibular joint was reconstructed using the graft. Following surgery, the boy was put on precise physiotherapy exercises to stabilize the treatment. Ankylosis as a result of injury to the TMJ was successfully treated. The boy had no difficulty in jaw movements and the asymmetry of the face was subsequently treated.

The boy with facial asymmetry with history of trauma to the TMJ

The boy with facial asymmetry with history of trauma to the TMJ

Profile view showing retruded lower jaw

Profile view showing retruded lower jaw

Profile view showing retruded lower jaw

Profile view showing retruded lower jaw

CT scan image showing fused right TM Joint

CT scan image showing fused right TM Joint

CT scan image showing abnormal jaw growth due to TMJ ankylosis

CT scan image showing abnormal jaw growth due to TMJ ankylosis

Bone graft taken from the rib

Bone graft taken from the rib

Graft used to reconstruct TMJ

Graft used to reconstruct TMJ

Defect correct following surgery

Defect correct following surgery

Profile view following successful TMJ reconstruction

Profile view following successful TMJ reconstruction

Profile view following successful TMJ reconstruction

Profile view following successful TMJ reconstruction

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