Temporomandibular articulation (ATM) and the bruxism
Do you suffer from a headache or cervical musculature?
If you suffers pains near the zone of hearing, pain to the palpation in musculature perioral, in the neck and the nape, and/or noises in opening and/or close the mouth, it could be the case that you suffer a joint temporomandibular disorder articulation.
The signs and symptoms previously described are some of the reasons of query that do us think that it exists one artritis or arthrosis of the articulation formed by : 1.The eminence of the pit of the bone storm, situated to the base of the skull, 2.The disk or menisco articular and 3.The condyle of the jaw , this is the called temporomandibular articulation ( ATM).
The paper of the bruxism in the of the ATM disorders
Some patients squeeze the teeth during the night, usually in going in in the deep dream and in going out of the same, but also during some moments of stress or maximum concentration during the day.
In tightening the teeth so much in position of maximum closing or in movements of extreme laterality (parafunctionals movements ) can produce :
- Dental wears: Depending of the type of tightening will be able to produce wears of the vertical dimension of the teeth, cracks and/or fissures, gingival retraccions ( the called injuries in V) and even dental fractures.
- Hipersensibity In the musculature: The perioral musculature how are the masseters ( to level of the cheeks until the zone of the hearing), the cervical musculature and of the neck and nape ( how are the esternoclidomastoïdal and the trapeze), can remain very sore, being able to appear the called “points trigger”, that are points of the committed musculature extremely painful to the palpation.
- Alterations of the articular disk: The fact that in tightening the teeth and do parafuncionals movements compress to the excess the articular disk can do that in opening the mouth this fine cartilage escape “” to in front producing a noise seemed to a click, many times audible for the people that find us next to the patient. In initials phases the cartilage recovers “” in closing the mouth, many times feel audible another click, but in phases very severe it could be the case that the disk do not recover , in such a case would produce a luxation of the ATM and would remain the open open until his subsequent relocation
of manual shape.
This affectation of the articulation can produce of shape uni or bilateral, being able to produce subluxations and luxations uni or bilateral.
When the artritis evolves to arthrosis…
When the artritis does not treat can evolve on a long-term basis to a arthrosis, in such marry the osseous surfaces of the bone storm and of the condyl mandibular friction between them without the coating discal as necessary, thus the noise happens to be audible how one crepitation
How to treat an Arthritis so that it does not evolve to Arthrosis…
When the patient comes to our office with an articular problem, we must treat several aspects:
- Detect problems of occlusion for malpositions or dental losses: The majority of the patients with disorders of the ATM have suffered variations in the dental contacts that have impacted in the stability of the articulation.
- Protect the articulation: Once corrected the occlusion (dental contacts) have to stabilize and protect the articulation with a device called discharge splint. To make this plate or splint only will be necessary to take some moulds and some relations with bites in wax of the occlusals contacts of the patient and will have all the necessary information.
In a next visit will adjust the discharge splint in the mouth of the to ensure us that establishes the relation intermaxillary correctly.
In occasions will be necessary the treatment for a physiotherapist and/or a osteopath for the total recovery of the articular disorder.
The function of the discharge splint is…
- We will avoid the dental wear: the fact to interpose a plate of rigid resin between upper and inferior arcade will do that the dental pieces can not contact between them and therefore they will not spend .
It is of special importance that the splint was made with rigid resin, since it is showed scientifically that the strengths “ are absorbed” by the rigid resin and do not transmit to the teeth. Instead, the protectors made of rubber ( how are the buccal protectors to practise sport) what do is cushion an impact but do not absorb the strength with what can transmit this strength and generate dental cracks.
- We will stabilize the articular disk: The splint of download has a thickness of some 3-5 mm that will do that the articular disk have of the necessary space to be suspended in the synovial fluid and can recover , giving place in cases no very severe to a regeneration on a long-term basis that it will do that they disappear even the clicks articulated as uncomfortable for the patient.
- We will relax the musculature involved: The muscular pains they will disappear after being treated, sometimes with the help of a physiotherapist, so that in being in distention during all night with the placing of splint in the morning will find “rested”.