Pohranychna Kh., Nazarevych M., Komnatska I., Dutka I., Meleh B.

CONTENTS

Scentific article

Introduction. Fractures of mandible take a leading place in the structure of maxillofacial area injury, and make up more than 85% of cases. Due to anatomical and physiological correlation between mandible and tem-poromandibular joint (TMJ), traumatic fractures of mandible directly affect its structural elements. The frequency and nature of the TMJ injuries greatly depends on the localization of the fracture, the force of impact and the degree of debris shifting, resulted in contusion of TMJ, ligamentous laxity, ligamentous disruption, dislocation , incarcera-tion and deformation of interarticular disk, capsule integrity damaging. Nowadays the only adequate diagnostic method of temporomandibular joint’s injuries is magnetic resonance imaging, which allows not only stating ana-tomical changes of the soft tissue and fibrous structures, but also acts as the basis for the selection of indications to certain treatment mode. The purpose of the research was to identify and unify structural damages of TMJ in traumatic fractures on the basis of the MRI data. Methods and materials. 22 patients with traumatic fractures of TMJ have been observed during the in-patient treatment at the departments of the oral surgery in Lviv. All patients were provided by magnetic resonance imaging to verify the diagnosis of fracture of the mandible articular process and determine the extent of damage to the soft tissue components of TMJ. Special reel for TMJs diagnostics was used for the MRI examination. Standard scanning has been conducted bilaterally in the following pulse sequences: PD, T1, T2, STIR, T2 * GRE. Changes related to the joint were evaluated in axial, coronal, oblique coronal and sagittal planes. Results of the research. While studying fractures of TMJ on the basis of MRI examination it has been estab-lished that their major part is complicated by TMJ injuries. Among the most frequent injuries of articulate structures are hemarthrosis (90,90%), disk dislocation (68,18%), disk deformity (54,54%), disk adhesion (36,36%), disk perforation (13,63%), ligamentous laxity (68,18%), ligamentous disruption (27,27%), injures of articular surface (22,72%). Concusions. Nowadays magnetic resonance imaging in assessing of anatomical and functional state of TMJ structures is far superior to other methods of diagnostics of maxillofacial areas pathologies of traumatic origins by the degree of informativeness. Most commonly TMJ fractures are attended with hemarthrosis, dislocation, deformation or damage of articular disk’s integrity, accompanied by ligamentous laxity or disruption. Timely detection of traumatic damage that occur in patients with TMJ fractures, allows determining treatment plan correctly and preventing the development of complications of dystrophic and degenerative nature.

magnetic resonance imaging, mandibular condyle fractures, TMJ injuries

• Варес Я. Е. Травматогенез і структура переломів нижньої щелепи / Я. Е. Варес, А. В. Філіпський, Т. А. Філіпська // Прак-тична медицина. – 2011. – №5. – С. 9-14.
• Магнито-резонансная томография ВНЧС в выборе тактики лечения больных с переломами мыщелкового отростка нижней челюсти / Т. В. Буланова [и др.] // Достижения и перспективы современной диагностики: Матер. Всерос. науч. Форума. – М., 2004. – С. 33-35.
• Магнито-резонансная томография в диагностике травматических повреждений височно-нижнечелюстного сустава / М. Х. Ходжибеков [и др.] // Медицинская визуализация. – 2002. – №1. – С. 34-37.
• Макєєв В. Ф. Критерії диференційної діагностики СНЩ розладів, класифікація та загально-клінічні підходи у діагностиці. Алгоритми додаткового дослідження СНЩС методами променевої діагностики / В. Ф. Макєєв, У. Д. Телішевська, Р. В. Кулінченко // Львівський медичний часопис. – 2012. –№1, Т. 18. – С. 38-42.
• Макєєв В. Ф. Частота та розподіл розладів за нозологічними формами скронево-нижньощелепних розладів / В. Ф. Макєєв, У. Д. Телішевська, Р. В. Кулінченко // Новини стоматології. – 2009. – №2. – С. 48-51.
• Погранична Х. Р. Пошкодження скронево-нижньощелепного суглоба при травматичних переломах нижньої щелепи // Х. Р. Погранична // Медицина транспорту України. – 2013. – №4. – С. 54-57.
• Deregibus A. Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disk displacement disorders / A. Deregibus, T. Castroflorio, J. DeGiorgi // Dento-maxillofac. Radiol. – 2013. – Vol. 42, №4. – P. 2012-2055.
• Kleinheins J. Fractures of the Mandidular Condyle: Basic Considerations and Treatment / J. Kleinheins, Ch. Mayer // Quintes-sence Publishing. – 2009. – P. 19-20.

«Bulletin of problems biology and medicine» Issue 2 part 2 (108), 2014 year, 084-088 pages, index UDK 616. 716. 4-001. 5-02:616. 724-001