Author/Editor		Gorjanc, Matija
Title		Bolečina v čeljustnem sklepu
Translated title		Temporomandibular joint pain
Type		članek
Source		In: Repše S, Tonin M, Tomažič A, et al, editors. Zbornik predavanj 41. podiplomskega tečaja kirurgije; 2006 feb 10-11; Ljubljana. Ljubljana: Kirurška klinika, Klinični center,
Publication year		2006
Volume		str. 159-71
Language		slo
Abstract		The aim of the paper is an overview of the most common painful diseases of the temporomandibular joint (TMJ). Among inflammatory and non-inflammatory diseases, bacterial and rheumatological arthritides as well as temporomandibular disorders (TMD) seem to be the most frequent. Understanding of TMJ pathology is based on the knowledge of functional anatomy of the joint. Fibrous disk has central structural and functional role. Diagnostic of the TMJ pain starts with history on its level, triggering factors, duration, localization, circadian rhytm and relieving procedures. History is also the key for distin guishing between local and systemic causes of pain. Myogenic and arthrogenic pain can be distinguished to an important extent on clinical examination. Imaging plays a supportive role and enables precise determination of underlying structural damage. Screening of calcified tissues is based on panoramic x-ray. Soft tissues can only be evaluated satisfactorilly by MRI. Arthritis of the TMJ is characterized by intensive spontaneous pain, aggravated by movement. Inflammatory signs can be found over diseased joint, trismus is typical. Pain accompanying TMD is cyclic in nature, painful periods are followed by spontaneous relieves. Obtuse pain usually starts with translation movement. If it is being accompanied by clicking, but with normal final mouth opening, anterior disc displacement with spontaneous reduction is the most probable diagnosis. Sudden disappearance of joint sounds, accompanied by locking of the jaws, suggests anterior disc displacement with spontaneous reduction. Etiologic treatment of the TMJ pain is most effective and desirable. As it is not always possible, additional goals of treatment should be encountered: establishment of function, relieve of pain and restitution of normal activities. When surgical treatment is indicated, minimally invasive techniques should be encountered first.
Descriptors		TEMPOROMANDIBULAR JOINT ARTHRALGIA ARTHRITIS TEMPOROMANDIBULAR JOINT DISORDERS TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME