Closed lock 4 months- got my MRI results. Opinions needed! - TMJ Disorder -TemporoMandibular Joint Message Board

violet89 · 05-14-2009, 07:04 AM

Hi

I have had a closed lock now going on 4 months. It came on suddenly & i never had jaw problems before this. my mouth NEVER opens beyond around 2cm. There is no pain at moment, just tightness inside at teh back of my mouth & all around my cheeks.
I finally got an MRI done & my specialist (& me) were expecting to see that my discs are anteriorly displaced without reduction. However the results came back normal in the closed mouth & open position (mind you, my mouth barely opens so I had to use the 2nd smallest tube to prop my mouth open) while they ran the MRI scan. The disc is at the 12 oclock position, which is where its supposed to be. The specialist is now thinking that it has to be purely a muscular problem.

Has anyone heard of a closed lock being musclular AND NOT caused by disc displacement? Is it possible that the radiologist got it wrong? Can you always trust the MRI report? Supposedly physiotherapy will help me..but i just can't understand how my muscles are so tight that my mouth won't even open.

Is there anything that the specialists could be overlooking & in fact somehow the disc is displaced but not showing up on the MRI? Are there any other scans I could be doing or is MRI very accurate?

Thanks!

Thelma-Louise · 05-14-2009, 08:46 AM

MRIs are supposedly quite thorough - but so are ICATs which are the dental version of a CT scan. But films and tests get misread all the time by radiologists. You may want to get copies of them - either digital or hard copy - and send them out to other specialists for their opinion - but your dr, if he is trained well, should be able to read them as well. When I started bringing my films to various drs I stopped bringing the written test report with me so the drs would have no preconceived idea of what they would see - I thought this might force them to take a closer look at the images. I wonder though how they got images of your discs in the open position if you couldn't open your mouth. Did the condyles or jaw bones show any abnormality?

Have you had any reconstructive work done on your back teeth?

How is your neck through all of this - do you have full range of motion in turning from side to side and is your head tilted forward or to one side? Does it crack at all? Has anyone checked the position of the atlas and axis? You may want to get an MRI or xray done of the c-spine - if there is no medical abnormality, NUCCA chiros or orthogonists can sometimes pinpoint an issue with alignment - since the lower jaw and neck share the same muscles, if your neck is off kilter, it could be inducing the closed lock.

I too have normal MRIs but was in such pain and no one could determine what was wrong and I allowed tmj dentists to adjust and alter my natural bite and at one point became totally locked on one side for several days - so closed locks can be muscular as I experienced it first hand - an unbalanced bite can cause it as can a mispositioned lower jaw.

MissHeadache · 05-14-2009, 09:19 AM

Hi, I don't have any opinions on what could be wrong, but I would suggest you get your scans read by another specialist. Also it was recommended to me that I have an MRI arthrogram, which is an MRI but they inject a dye into the joint. supposedly it shows a bit more detail. I haven't had one (UK, no insurance, etc) so can't tell you if they are any good but if you have good insurance then maybe ask for one. Good luck.

violet89 · 06-13-2009, 02:55 AM

Hi

I am struggling to find any TMJ specialists here in Australia- I have been seeing a phyiotherapist who said he knows a very good radiologist, so he said he will get a second opinion for me regarding my MRI scan. The physiotherapist has been very hesitant to work on my mouth because he is also unsure of the cause of my lock ie disc displacement OR muscle spasm. He has just been giving me some basic stretching exercises to do at home, but I have had little improvement.

My mouth has such limited movement- it only opens up and down around 2.5 cm now max and I can't really move my jaw from side to side either. The physiotherapist says to put my tongue on the back of my top front teeth and slowly open my mouth- but this is REALLY difficult! I don't get any sharp pains, but I feel a massive amount of resistance and my mouth barely opens when he says to do that stretch. It seems almost impossible to me that muscle spasm is causing such restrictive movement..has anyone experienced limited mouth opening?

Jill 227 · 06-13-2009, 07:49 AM

HI--It sounds like you are truly locked closed. When it happened to me, I believe the right side (disc) dislocated due to clenching my teeth one night before I got my nightguard. If you are locked, along with muscle tension, you will NOT be able to move side to side at all very well. I think I was able to still move one way, but when I tried to move my jaw in the other direction, it just absolutely stopped. Also, you will feel your jaw just stop opening when you try to open wide. Usually if it's only muscular, after stretches and massage, you will be able to open wider, but if you definitely are locked, your jaw will just stop opening at some point, (measurement). Something you can try that really helps spasms and actually disc recapture, I know this works because this is how my dentist unlocked me, is to gag yourself. Not a small gag, but like if you were to vomit pretty hard. This is the only way I was able to get unlocked, twice, I might add. The position the gagging puts your jaw in sometimes is able to pop the disc back in place. I'm living proof it worked. Put moist heat on your jaw first, and try it. If you have any questions, PM me and let me know. I know it sounds insane, but not all tmj guys do that. They'll send you to a chiropracter, which didn't work for me at all. This is the only thing that did it. ---J.