DIAGNOSTICS OF TEMPOROMANDIBULAR JOINT PATHOLOGY OF OCCLUSIVE ORIGIN

Novikov V. M., Shtefan A. V.

CONTENTS

Scentific article

Occlusal disorders of dentoalveolar system can be both the cause and the aggravating factors in the whole complex of dental diseases. This investigation is a part of implementation of the subject matter, entitled «The Impact of Anthropogenic Environmental Factors on the Urban Population» (No. 0107U002291). The author is the direct executor of the indicated theme. The analysis of the immediate and long-term results of applied methods for complex treatment of patients with pain syndrome (PS) of TMJ dysfunction showed their physiologic and high efficiency, and improvement of hospital treatment due to impact on all stages of the PS TMJ pathogenesis, as mandible position is fixing-up and spatial correlation of TMJ’s elements are optimizing, biological activity of chewing muscles are becoming normal with elimination of its overloading during mastication. Having analyzed patients’ anamnestic data as for their disappointments from specialist to specialist, caused by the noise and/or pain, generated in one or both temporomandibular joints, the authors concluded that there is a lack of professional awareness of dentists as for the expertise and amount of medical treatment, provided to pa-tients of this category. Some patients have an appointment after consultations with dental surgeons with diagnosis of arthrosis-arthritis, other come after consultations with otorhinolaryngologists, neurologists and even psychia-trists, whom patients have been referred by dentists. Such visits delay the time for patients’ care, impeding their treatment. 93 people (69 women and 24 men), aged from 16 to 73, with clinical manifestations of PS TMJ have been involved into clinical study. Results of the research. The analysis of study casts’ measuring, made in 93 patients with temporomandibular joint pain syndrome of occlusive origin showed that asymmetrical laterally-directing supracontact (fillings, crowns or artificial teeth, protruded or shifted natural teeth) has been observed in prevailing majority of cases (68,82%). These patients were included into Group I. 12, 9% of patients with bilateral symmetrical mesially-directing supracontact (fillings, crowns or artificial teeth, protruded terminal upper teeth) were included into Group II. 18,28% of patients with symmetrical distally-directing supracontact (fillings, crowns or artificial teeth on the frontal area, protruded terminal lower teeth) were included into Group III. Summing up, it should be noted that lack of appropriate preventive measures and (or) timely professional dental care, especially orthopedic one, results in loss of lateral teeth support or occurrence of occlusal barriers (supracontacts) that leads to changes in the position and movements of the mandible, to its displacement in either direction. Against this background, in genetically predisposed people under the influence of the psycho-emotional factors (stress), spasm of external pterygoid and other masticatory muscles develops with the formation of “trigger points” that, depending on the type and degree of mandible displacement, will be typical for TMJ clinical picture. The patterns of clinical manifestations and geometric analysis of study casts allow the experienced specialist to distinguish, to a certain extent, a pain syndrome of dysfunction from similar diseases, to determine the cause and prescribe the proper treatment and refer patients to specialized gnathological centers only if there is no positive result.

PS TMJ, occlusion, supracontacts

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«Bulletin of problems biology and medicine» Issue 2 part 2 (108), 2014 year, 049-055 pages, index UDK 616. 724-007-07