口腔颌面外科学（中山大学）15颞下颌关节病ppt课件.pptVIP

Treatment (1) Reversible treatment A. Patient education; B. Diet; C. Medication; D. Physical therapy; E. Splints (2) Permanent occlusal modification (3) Temporomandibular joint surgery A. Arthroscopy; B. Disk repositioning surgery C. Disk repair or removal; D. Arthroplasty for OA; E. Total join replacement Reversible treatment Diet Load reduction in the TMJ is achieved by modifying the patient’s diet to reduce joint loading from forces of mastication. This is achieved primarily by a non-chewing diet such as liquid or pureed food. Reversible treatment Pharmacologic Agents The nonsteroidal anti-inflammatory drugs (NSAID) Antidepressant medication Other medications such as tranquilizers, muscle relaxants, sedatives, and narcotic pain medications Reversible treatment Physical Therapy (PT) PT in conjunction with other methods of treatment is used to relieve musculoskeletal pain and improve range of motion Reversible treatment Injections Injections of tender muscles, trigger areas, and/or joint spaces with local anesthetic solution relief of symptoms. Corticosteroid injection can be effective in reducing capsulitis The use of Botox to eliminate muscle spasm and reduce strength of contraction Reversible treatment Splints Autoposition Splints Reposition Splints Permanent occlusal modification Surgical Treatment 1. Arthrocentesis 2. Arthroscopy 3. Arthroplasty (Condylotomy) 4. Arthrotomy Disk repositioning, Disk repair or removal 5. Other Procedures Coronoidotomy/coronoidectomy Styloidectomy (Eagle’s Syndrome) Clinical Classification Functional disorder Structural disorder Inflammatory diseases Osteoarthrosis Functional disorder L. Pterygoid M. hyperfunction L. Pterygoid M. spasm Masticatory muscle spasm Post. band injury Structural disorder Anterior disk displacement with reduction Anterior disk disp1acement Without reduction Capsule enlargement and disc attachment flexibility