TMJ (Jaw)
TMJ Osteoarthritis
턱관절 골관절염
Degenerative cartilage and bone changes with crepitus and pain
- How common
- Common (age 40+)
- Typical age
- Age 40+, female predominant
What is it?
Repetitive loading and biomechanical stress wear cartilage, causing subchondral sclerosis, cysts, and osteophytes.
Commonly affected: Cartilage/bone of condyle, fossa, and articular eminence
How it develops
- Cartilage WearLoss of condylar/fossa cartilage
- Subchondral ChangesSclerosis and cyst formation
- Osteophyte FormationMarginal bony proliferation
- Condylar Flattening/ErosionCondyle flattens with irregular surface
Symptoms
- Joint painJoint pain worse with chewing
- CrepitusGrinding/sandpaper sound (bone-on-bone)
- Morning stiffnessStiffness resolving within 30 min
- Mild-moderate opening limitationOpening 35–40 mm
- Occlusal changesAltered bite from condylar erosion
How it is examined
- Joint crepitusCrepitus palpable/audible
- Joint tendernessLateral pole tenderness
- Limited opening35–40 mm (mild-moderate)
- Occlusal assessmentPossible posterior open bite from condylar loss
Imaging
Panoramic or CBCT best for bony changes.
- Condylar flattening
- Osteophytes
- Joint space narrowing
- Subchondral sclerosis/cysts
MRI evaluates soft tissue, disc, marrow edema, effusion.
- Commonly with disc displacement/deformation
- Joint effusion
- Condylar marrow edema (active)
- Cartilage loss
Non-surgical care
- Education/soft dietReduce chewing load, manage bruxism
- NSAIDs + acetaminophenPain and inflammation control
- Stabilization splintRedistributes joint loading
- PT and injectionsJaw exercises, intra-articular hyaluronate/steroid
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Severe pain/dysfunction failing 6+ months conservative
Procedures that may be discussed
- Arthroscopy with lysis/lavage
- Arthroplasty (condyloplasty)
- Total joint replacement — end-stage
Outlook
Most controlled with conservative care; surgery for end-stage disease.