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środa, 4 stycznia 2017

zespól stawu skroniowo - żuchwowego - TMJ -BORELIOZA

zespól stawu skroniowo - żuchwowego - TMJ jest czwartym z najczęściej dotkniętych stawów przy Boreliozie.

http://lyme.wikia.com/wiki/Temporomandibular_joint_(TMJ)

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W badaniu 120 pacjentów z Borelioza :
75 procent pacjentów zgłaszało ból w mięśniach - żuchwa
72 procent zgłaszało bóle stawów skroniowo - żuchwowych
25 procent pieczenie w ustach
70 procent  ból gardła.
47 procent pacjentów odwiedziło co najmniej 10-u  lekarzy zanim uzyskało prawidłowa diagnozę

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Nasilenie odczynu zapalnego zależy od czynników miejscowych, penetracji bakterii w głąb tkanek i stanu ogólnego chorego

Przewlekłe zapalenie stawu skroniowo- żuchwowego (arthritis temporomandibularis chronica) Niekiedy bywa zejściem ostrego zapalenia, częsciej rozwija się od początku przewlekle, głównie u osób w podeszłym wieku Przyczyną są wpływy hormonalne, nerwowe, naczynioruchowe, alergiczne, zakażenie od ogniskowe  Czynnikiem przyspieszającym rozwój schorzenia jest przeciąźenie stawu na tle zaburzeń zgryzu i zwarcia (braki w uzębieniu)

Objawy kliniczne: - w większości przypadków okolica stawów jest bez zmian
nieznaczny obrzęk,
bolesność okolicy stawu
trzeszczenie w czasie ruchów
zbaczanie żuchwy na stronę chorą
ogólny stan chorego dobry
Leczenie:

usunięcie ognisk zakażenia
uzupełnienie braków zębowych i regulacja zgryzu
mechanoterapia - mechanoterapia
stosowanie diatermii lub ultradźwięków

Kiłowe zapalenie stawu skroniowo- żuchwowego (arthritis temporomandibularis luetica) Może mieć postać zapalenia torebki maziowej (synovitis) z uszkodzeniem chrząstki stawowej, wysiękiem i powstaniem artropatii, a nawet zesztywnieniem stawu.Obraz kliniczny jest podobny jak w przewlekłym zapaleniu nieswoistym.

 http://slideplayer.pl/slide/409990/

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Pacjenci mający zespól stawu skroniowo żuchwowego  TMJ - powinni być badani pod katem Boreliozy.                                                                                                                              
                                                                                                                                
Due to the high incidence of Lyme disease, the ease with which it can be misdiagnosed, and its potential for causing irreversible neurologic or cardiac complications and fatalities if left untreated, all patients living in known epidemic areas who manifest intractable facial pain, or what appears to be a case of temporomandibular joint syndrome that does not respond to therapy should be tested for Lyme Borelliosis. It should be remembered however, that not all patients with active Lyme disease produce antibodies, and it is thus imperative for the clinician to obtain a detailed patient history with a focused series of questions directed at the known presentations of the disease, with specific emphasis placed on the prior appearance of an ECM lesion.

https://www.ncbi.nlm.nih.gov/pubmed/2812630

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Borelioza -  zaburzenia stawu skroniowo-żuchwowego.

Craniomandibular disorders cause many pleomorphic and seemingly unrelated clinical manifestations that mimic other more serious medical problems and thus can present physicians and dentists with a challenge that invites misdiagnosis and improper treatment planning. Conversely, misdiagnosis and ineffective treatment planning are facilitated when serious medical problems manifest a range of signs and symptoms that are clinically similar to temporomandibular joint muscle dysfunction. At times, the patient's response to therapy may be the best method of corroborating a diagnosis, as illustrated in this report of a patient with Lyme disease that was misdiagnosed as a temporomandibular joint disorder. Lyme disease has already reached epidemic proportions in several parts of the United States and its geographic distribution is spreading. Because Lyme disease is a life-threatening illness whose clinical manifestations can mimic temporomandibular joint/myofascial pain-dysfunction, it is the responsibility of every dentist who treats craniomandibular disorders to become familiar with the clinical presentations of Lyme disease and more proficient in its differential diagnosis.

https://www.ncbi.nlm.nih.gov/pubmed/2295991
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While trauma to the jaw as a result of an accident is a leading cause of TMD, there are many diseases and conditions that can also affect the TM joints. Patients who have Lyme disease, Psoriatic arthritis or Lupus, for example, may experience joint inflammation, swelling, stiffness and pain in around the TMJ. A thorough examination can determine if one of these conditions is causing your TMJ pain

http://www.tmjsurgery.com/AboutYou/Arthridities

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We received the following patient comment from Gillian in response to the article in our April TMJ News Bites, “Avoid a TMD Misdiagnosis, Watch Out for Lyme Disease”.
I was SO happy to see that your latest newsletter included information about Lyme disease and jaw symptoms.
I have been on antibiotics for nearly 11 months since I was diagnosed with late disseminated Lyme disease.   If you remember, I had had a filling done, after which I developed severe jaw pain, a locked jaw and neck and shoulder pain.  Several months later, I developed swollen joints in my fingers, toes and severe foot pain.  This was accompanied by chronic migraine headaches, muscle pain and severe fatigue. I was finally diagnosed with Lyme disease by my cardiologist, but by then I had already had it in my body for perhaps 10 years or more.


https://fullcircledme.wordpress.com/2012/05/28/lyme-disease-tmj-misdiagnosis/

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Lyme disease is an increasingly common problem that has spread rapidly across the United States. A case of the disease and its correlation to TMJ pain and dysfunction in a 35-year-old female is described. The patient was diagnosed and cured of her symptoms with antibiotics, possibly sparing her from surgery.

https://www.ncbi.nlm.nih.gov/pubmed/3422274
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Lyme disease involving the temporomandibular joint

http://www.joms.org/article/0278-2391(88)90306-0/abstract

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"Unfortunately, most patients are not diagnosed properly until their Lyme disease is at a later stage, when it is more difficult to treat," says AGD spokesperson Manuel Cordero, DDS. "Diagnosing this disease is very tricky because it can hide itself behind many dental problems, including toothaches and jaw pain."

"Your dentist may suspect Lyme disease if you have a mysterious toothache that can't be attributed to cavities," says Dr. Cordero.

In the study, about 70 percent of patients with Lyme disease reported dental pain in the absence of dental disease, and the dental pain tended to move from tooth to tooth. Of these patients, 36 percent had multiple dental treatments, including root canals and tooth extraction unnecessarily.

"Early diagnosis is critical because in its late stages, Lyme disease can lead to neurological symptoms and arthritis and can involve the heart and other organs," says Dr. Cordero. "Filling out a proper medical history will help the dentist detect this mysterious disease."

The majority of Lyme disease patients are found in the Northeast, but the disease has also been reported in the North Central and Pacific Coast regions. Up to 25,000 people in the United States contract Lyme disease each year.

http://www.victoriadentalgroup.com/lyme-disease-have-you-ticked--sdterms.html

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1988 Lyme disease involving the temporomandibular joint.

https://books.google.nl/books?id=K035mlSXAAsC&pg=PA200&lpg=PA200&dq=Lyme+disease+involving+the+temporomandibular+joint&source=bl&ots=LSMNF04ovn&sig=tbsx56eXjVFwh0eG7jBWyrULync&hl=pl&sa=X&ved=0ahUKEwjqhqWajqjRAhVNahoKHR5JAwcQ6AEIVTAH#v=onepage&q=Lyme%20disease%20involving%20the%20temporomandibular%20joint&f=false

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TMJ is a condition in which pain in the jaw area and surrounding tissues limits the function of the jaw itself. TMJ can affect a patient's ability to sleep, work, swallow chew and even breathe. TMJ patients may experience other symptoms and medical conditions such as chemical sensitivity, chronic fatigue syndrome, endometriosis, fibromyalgia, hypermobile joints, irritable bowel syndrome, mitral valve prolapsed, sleep disorders and vulvodynia. Medical conditions such as ehlers-danlos syndrome, dystonia, lyme disease and scleroderma may also plague patients.

 http://www.dr-ray.com/services_tmj.php#ixzz4UmZfnDiM
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