Example: tourism industry

Trismus: Aetiolog Diffy, erential Diagnosis and …

O R A L S U R G E ROY R A L S U R G E R Y. Trismus: Aetiology, Differential Diagnosis and Treatment DHANRAJANI AND O. JONAIDEL. movement is 8 12 mm. Abstract: trismus is a problem commonly encountered by the dental practitioner. It It is very important that dentists are has a number of potential causes, and its treatment will depend on the cause. This familiar with the differential Diagnosis of article discusses the primary causes of this condition and the various treatments available. limited jaw opening,14 as some of the conditions attributed to it can be life Dent update 2002; 29: 88 94 Good perception of its causes can help the dentist to refer the Clinical Relevance: Dental professionals should realize that trismus can be a patient early for specialist care.

88 Dental Update – March 2002 ORAL SURGERY Abstract: Trismus is a problem commonly encountered by the dental practitioner. It has a number of potential causes, and its treatment will depend on the cause.

Tags:

  Update, Trismus

Information

Domain:

Source:

Link to this page:

Please notify us if you found a problem with this document:

Other abuse

Transcription of Trismus: Aetiolog Diffy, erential Diagnosis and …

1 O R A L S U R G E ROY R A L S U R G E R Y. Trismus: Aetiology, Differential Diagnosis and Treatment DHANRAJANI AND O. JONAIDEL. movement is 8 12 mm. Abstract: trismus is a problem commonly encountered by the dental practitioner. It It is very important that dentists are has a number of potential causes, and its treatment will depend on the cause. This familiar with the differential Diagnosis of article discusses the primary causes of this condition and the various treatments available. limited jaw opening,14 as some of the conditions attributed to it can be life Dent update 2002; 29: 88 94 Good perception of its causes can help the dentist to refer the Clinical Relevance: Dental professionals should realize that trismus can be a patient early for specialist care.

2 Common problem. Treatment of trismus may be relatively easy or complicated. It is important to remember that multiple potential causes exist. CAUSES OF trismus . Several conditions may cause or predispose an individual to develop trismus . The aetiology of trismus may be classified as follows: T rismus is an inability to open the mouth. According to Dorland's Illustrated Medical Dictionary1 trismus applied to restrictions of movement resulting from extra-articular joint abnormalities. This latter type of .. infection;. trauma;. (Greek Trimos: grating', grinding') is ankylosis is what most clinicians know dental treatment.

3 As temporomandibular joint disorders;. a motor disturbance of the In a busy practice, it is not unusual to tumours and oral care;. trigeminal nerve, especially spasm see several patients each month with a drugs;. of the masticatory muscles, with complaint of trismus . This condition radiotherapy and chemotherapy;. difficulty in opening the mouth, a may impair eating, impede oral hygiene, congenital problems;. characteristic early symptom of restrict access for dental procedures and miscellaneous disorders. tetanus. adversely affect speech and facial appearance. These are summarized in Figure 1 and trismus has a number of potential will be described below.

4 Causes, which range from the simple and non-progressive to those that are What is Normal Opening of potentially 6 the Mouth? Infections Kazanjian7 divided ankylosis of the The normal range of mouth opening The hallmark of a masticatory space temporomandibular joint into true and varies from patient to patient, within a infection is limited jaw opening. trismus false. The true type of ankylosis was range of 40 60 mm, although some may be related to dental infections and attributed to pathological conditions of authors place the lower limit at 35 ,10 must be systematically evaluated so that the joint, and false ankylosis was The width of the index finger at the nail a potential life-threatening situation is bed is between 17 and 19 mm.

5 Thus, two discovered as early as possible. fingers' breadth (40 mm) up to three Infections causing trismus may be of Dhanrajani, FRACDS, FDS RCS, FFD RCSI, fingers' breadth (54 57 mm) is the usual an odontogenic or non-odontogenic Consultant, Oral Medicine, and O. Jonaidel, BDS, width of ,12 Evidence suggests nature. Odontogenic infections have MSc (Oral & Maxillofacial Surgery), Specialist, that gender may be a factor in vertical three major origins: pulpal, periodontal Oral & Maxillofacial Surgery, Riyadh Dental mandibular opening. In general, males and pericoronal. The presence of an oral Centre, Riyadh, Kingdom of Saudi Arabia.

6 Display greater mouth Lateral infection, particularly around an 88 Dental update March 2002. O R A L S U R G E RY. trismus . (Aetiology and differential Diagnosis ).. Intra-articular 1. Ankylosis Extra-articular 2. Arthritis synovitis 3. Meniscus pathology .. Infection Trauma Dental-treatment TMD Tumours and Drugs Radiotherapy and Congenital Miscellaneous related oral care chemotherapy .. Odontogenic Non- .. * Post-extraction . * Primary and secondary * Osteoradionecrosis * Hysteria Odontogenic * Local anaesthetic tumours of epipharyngeal * Post-radiation fibrosis * Lupus Erythematosus * Pulpal * Tonsillitis injection and parotid region, jaws joint.

7 * Hypertrophy of coronoid * Periodontal (Peritonsillar * Submucus fibrosis * trismus pseudo camptodactyly * Pericoronal abscess) * Myositis ossificans * Phenothiazine syndrome * Tetanus * Succinyl choline * Meningitis * Trauma to TMJ * Tricyclic antidepressant * Brain abscess due to wide and * Metaclopramide * Parotid abscess prolonged opening * Halothane * Myofascial muscle spasm . * Fracture mandible * Internal derangement * Fracture zygomatic arch * Incorporation of foreign bodies Figure 1. Aetiology of trismus . erupting mandibular third molar, is the temporomandibular joint (TMJ) Ideally, the needle should be placed in most common Severe symptoms in which trismus was a the pterygoid space, which is bound by odontogenic infections involving the specific traumatic event.

8 The records of the internal oblique ridge of the muscles of mastication are often 779 patients were reviewed and of mandible on the lateral side and accompanied by trismus at initial cases had trismus within one week of pterygomandibular raphe on the medial presentation. This infection, if the event. side. Occasionally, the medial pterygoid unchecked, can spread to various facial trismus has also been reported due to muscle is accidentally penetrated or a spaces of the head and neck and lead to the accidental incorporation of foreign vessel is punctured and a small bleed serious complications such as cervical bodies because of external traumatic follows: a haematoma can occur in the cellulitis or Another relatively rare cause of muscle bed and subsequently organize, Non-odontogenic infections such as trismus seen in general practice is causing a fibrosis.

9 trismus due to this tonsillitis, tetanus, meningitis, parotid trauma of the zygomatic arch and cause can be protracted and quite abscess and brain abscess may also zygomaticomaxillary complex (ZMC), cause ,18 which interferes with the movement of Hot packs, stretching exercises using the coronoid wooden spatulas and reassurance are usually sufficient for this condition, Trauma although sometimes the haematoma Fractures, particularly those of the trismus Related to Dental becomes infected and requires surgical mandible, may cause limited jaw Procedures evacuation. opening. Depending upon the type of Oral surgical procedures may result in injury and the direction of the traumatic limited jaw opening.

10 The extraction of force, fractures of the mandible may teeth may also cause trismus as a result Temporomandibular Joint occur in different locations, producing either of inflammation involving the Disorders mandibular hypomobility. muscles of mastication or direct trauma There are numerous subcategories of Backland et defined trauma as a to the TMD, a number of which may be devastating event ( sports injury), Another common cause of trismus associated with trismus . TMDs may be administration of general anaesthesia often seen in general practice is the divided into extracapsular (mainly and performance of a dental procedure limited mouth opening that occurs 2 5 myofascial) and intracapsular problems such as difficult extractions or other days after a mandibular block has been (including disc displacement, arthritis, treatment requiring lengthy administered.)


Related search queries