Proshchenko A. M., Vovk V. V.

ALGORITHM OF ORTHOPEDIC TREATMENT OF PATIENTS WITH OCCLUSIVEARTICULATION DISORDERS AND DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT

---

Show/Download

About the author:

Proshchenko A. M., Vovk V. V.

Heading:

DENTISTRY

Type of article:

Scientific article

Annotation:

The aim of the study is to evaluate the effectiveness of orthopedic treatment of occlusal-articulation disorders in temporomandibular joint dysfunction, conducted according to the proposed algorithm. A total of 150 patients with occlusal disorders and temporomandibular joint dysfunction were examined and treated. The study involved assessing pain intensity, evaluating the status of functional occlusion, and conducting synchrography and cone-beam computed tomography. The algorithm for orthopedic treatment included the following steps: preparatory measures, occlusal therapy, fixation of the newly established centric relation of the jaws and interalveolar height, creation of a prototype for permanent structures, and final fixed prosthetic treatment. After the conducted orthopedic treatment, the number of patients with pain syndrome reduced, with 17 (11.33%) patients reporting pain compared to 60 (40.00%) before treatment (p≤0.05). The intensity of pain, as measured by the visual analog scale, was reduced by half – 0.93±0.71 points compared to 3.97±1.47 before treatment (p≤0.05). Pathological joint sounds remained in 14 (9.33%) patients out of 89 (59.33%) (p≤0.05) after treatment. Limitation of mouth opening, present in 57 (38.00%) patients before treatment, remained in 28 (18.67%) patients post-treatment (p≤0.05). Persistent mandibular displacement was observed in 76 (50.66%) patients, a 40% reduction compared to pre-treatment data (p≤0.05). This was confirmed by cone-beam CT findings: the average ratio of the mesial/distal joint space after treatment was 1.00±0.19 in the right TMJ and 1.02±0.01 in the left TMJ, compared to 2.05±0.72 in the right TMJ and 1.40±0.94 in the left TMJ before treatment (p≤0.05). Analysis of the neuromuscular characteristics of the dentoalveolar apparatus showed an average post-treatment value of 80.69±2.10 compared to 68.81±4.24 before treatment (p≤0.05). The effectiveness of the proposed treatment algorithm is confirmed by the reduction in pain intensity, the elimination of pathological joint sounds, an increased range of painless mouth opening, improvement in the neuromuscular characteristics of the dentoalveolar apparatus, and stabilization of the mandibular head position, as demonstrated by cone-beam CT data.

Tags:

Bibliography:

1. Kapos FP, Exposto FG, Oyarzo JF, Durham J. Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management. Oral Surg. 2020;13(4):321-34. DOI: https://doi.org/10.1111/ors.12473.
2. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017;37(7):692-704. DOI: https://doi. org/10.1177/ 0333102416686302.
3. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6:301-355.
4. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Amp Facial Pain Headache. 2017;28(1):6-27. DOI: https://doi.org/10.11607/jop.1151.
5. Costen JB. A Syndrome of Ear and Sinus Symptoms Dependent upon Disturbed Function of the Temporomandibular Joint. Ann Otol Rhinol Amp Laryngol. 1997;106(10):805-19. DOI: https://doi.org/10.1177/00034894971 0601002.
6. Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: Past, present, future. J Dent Res. 2016;95:1093-1101.
7. Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, et al. Painful Temporomandibular Disorder. J Dent Res. 2016;95(10):1084-92. DOI: https://doi.org/10.1177/0022034516653743.
8. Lekaviciute R, Kriauciunas A. Relationship Between Occlusal Factors and Temporomandibular Disorders: A Systematic Literature Review. Cureus. 2024;16(2):e54130. DOI: https://doi.org/10.7759/cureus.54130.
9. Sherman SA, Eisen S, Burwinkle TM, Varni JW. The PedsQL™ Present Functioning Visual Analogue Scales: preliminary reliability and validity. Health Qual Life Outcomes. 2006;4(1):75. DOI: https://doi.org/10.1186/ 1477-7525-4-75.
10. Bashar AK, Kabir MN, Ghosh R, Sajedin M, Rahman MM. Early Inflammatory Response of Dental Pulp in Response to Biodentin and Mineral Trioxide Aggregate as Pulp-capping Agents. Mymensingh Med J. 2023;32(4):1038-1045.

Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 3, 174, 408-419 pages, index UDC 616.724-008.6-073.7:616.314-089.23

DOI:

10.29254/2077-4214-2024-3-174-408-419