In humans, there is a small joint in front of the ear called the temporomandibular joint, which connects the skull to the mandible. It is this joint that allows the jaw to move and perform its functions, and it is the joint that moves most frequently throughout the body. Some people have a popping sound in the TMJ when opening or closing the mouth, and the opening pattern and degree of opening are abnormal. Since the early stage does not affect daily life and work much, most people do not seek medical attention in time until the later stage, when the joint lesion is serious, the opening of the mouth is restricted and the pain is unbearable. This is temporomandibular joint disorder, which is one of the common diseases of the oral and maxillofacial area, and is most common in young adults and women, with the highest prevalence rate of 28% to 88% at the age of 20-30. TMJ disorders are divided into masticatory muscle disorders, structural disorders, inflammatory diseases and osteoarthrosis. The main features are popping during joint movement, pain and soreness in the joint area, and disorders of mouth opening movement. In this article, we will explain the sound of the temporomandibular joint. There are three main types of TMJ popping and murmuring sounds: popping sound, crushing sound and friction sound. Each of them has its own causes. ①”Popping sound”: popping sound is the sound of “click, click” in the movement of the opening, which is mostly a single sound, sometimes a double sound. The TMJ popping sound is mainly due to the change of the position of the joint disc and condyle, and is produced by the “squeezing” of the joint disc and condyle during the opening and closing of the mouth, which is a relatively crisp sound and can occur in the early, middle, or late stage of mouth opening, and changes with the change of the disease. There is also a kind of popping sound, which occurs at the end of the opening, mainly caused by the hyperfunction of the extra-parietal muscles, because the extra-parietal muscles are hyperfunctional, pulling the condyles to move forward excessively, opening the mouth very much, and even the joint is “semi-dislocated”. ②”Broken sound”: mainly that is, the opening movement has a “click, click” sound, mostly double or multiple such sounds are mostly seen in the TMJ disk perforation, joint disk rupture and other diseases. The articular disc is located between the articular fossa, the articular tuberosity and the condyle, and is oval in shape, with the inner and outer diameters greater than the anterior and posterior diameters. ③ “friction sound”: that is, the opening movement has a continuous, like rubbing cellophane friction sound, osteoarthrosis, cartilage surface roughness can appear such sound. This sound can occur in patients with osteoarthrosis and rough cartilage surfaces. It is most often seen in patients with destruction and resorption of condylar bone and uneven condylar surfaces. Treatment plan Regarding the treatment of joint popping and murmur, there are many different treatment principles: some doctors say that there is no need for treatment, while some experts say that treatment is needed. After a long period of clinical treatment, I think: no matter how small the sound is, if it affects the patient’s life and the patient feels very uncomfortable, it should be treated; on the other hand, no matter how loud the sound is, if the patient feels fine and does not have any effect, and if it does not cause bone damage or pain, it can be left untreated. We use a “gradient treatment method”, as follows: ① Conservative treatment method: generally use the “3M” method, including physical therapy, manipulation reset, oral exercises (see my other personal public micro-signal science article). ②Injection therapy: also called “elasticity supplementation therapy”, one of the components of joint fluid: medical sodium hyaluronate gel or medical chitosan, injected into the joint cavity to play the role of “lubrication, repair, antibacterial, balance”, so as to reduce or inhibit the sound or popping This can reduce or inhibit the sound or popping. (3) Occlusal plate treatment: Various forms of occlusal plates are used to adjust the position of the “condylar disc”, so as to gradually establish a stable relationship between the “condylar disc”. This stabilization will lead to a new position of the articular disc, thus reducing the sound. There are dozens of articular discs, but the most commonly used ones are within ten types, such as: repositioning occlusal plates, stable occlusal plates, posterior arch occlusal plates, YWIN-BLOCK, etc. Minimally invasive temporomandibular arthroscopy: Arthroscopy has been used in the treatment of temporomandibular joint diseases for more than 20 years, but for various reasons, it is still far from being promoted in China, which is related to the changing philosophy of temporomandibular joint disease treatment and the poor efficacy of arthroscopic treatment. Our experience is that TMJ arthroscopic release and lavage have certain therapeutic effects for cases with severe intra-articular adhesions and inflammation in the displaced joint disc. ⑤ Open surgery (articular disc anchorage): For patients with displaced articular discs, especially those with bone destruction and popping murmur, open surgery can be used if the previous methods are not effective. A small number of domestic experts have achieved certain results in the treatment of articular disc displacement by using the “articular disc anchorage” procedure, and some articles have been published in domestic and international journals. For a very small number of patients (5% of patients), we also use open surgery.