Malocclusion as a Cause of Pain in the Temporomandibular Joint
At the present time, considerable importance is attached to abnormalities of the temporomandibular joint, especially as they apply to the symptoms of pain referred over the branches of the fifth nerve. These symptoms include tinnitus, deafness, a chronic catarrhal otitis media, glossodynia, xerostomia, eczema of the auditory canal, and vertigo. It is a moot question how often these symptoms are referable to abnormality of this joint.
In the last two decades, considerable investigation has been carried out on the problem of malocclusion from the anatomical, clinical, and histological standpoints. Wright1 in 1920 and Monson2 in 1921 presented papers showing the rôle of adjustment of the dental bite in the treatment of deafness. Kirk3 demonstrated the anthropological basis of these findings and produced mathematical proof that trauma of the ear could result from the stress of abnormal dental occlusion. Prentiss4, Maves5, Goodfriend6, Cryer7, and most recently Costen8 have contributed to the establishment of a syndrome associated with temporomandibular dyscrasia.
Joint disease in the absence of symptoms is a well-recognized entity. Redfern in 1850 first observed this and stated that joint diseases at times progress until complete destruction of the cartilage has resulted without the patient being aware of any abnormality. On the other hand, these same types of disease may cause violent pain and irritation. The symptoms supposed to indicate disease in the cartilage are closely allied with those produced by affections of the bone. Politzer in 1878 observed that the anterior wall of the bony auditory meatus was often pierced. . .