Ekaterinburg, Ekaterinburg, Russian Federation
Ekaterinburg, Ekaterinburg, Russian Federation
Subject. Syndrome of pain dysfunction of the temporomandibular joint is one of the common pathologies of TMJ. Patients with this diagnosis complain of a violation of the movements of the lower jaw, discomfort and pain in the joint. The writings of many authors contain a deep and comprehensive discussion of various aspects of this problem, and scientific justification is given that TMJ dysfunction is almost always accompanied by muscle symptoms. One method of treatment is the use of occlusal splints. In this regard, the task of determining the effectiveness of eliminating muscular-articular dysfunction using individual occlusal splints is relevant. The aim of the study was to determine the effectiveness of treatment of TMJ dysfunction with occlusal splints according to kinesiography. Methodology. The kinesiographic study on the Myotronics K7 apparatus consisted of sequentially performing functional tests (opening and closing the mouth, lower jaw movements to the side) and using the method of percutaneous electroneurostimulation. In the treatment of all patients, an occlusal positioner splint was used, which was made individually in an articulator using an interocclusal register in the neuromuscular position of the lower jaw. The average treatment period was 4.5 months with monthly adjustments to the occlusal splint. Results. As a result of treatment with the use of the occlusal splint, disturbances in the trajectory in the transverse (in 70 % of cases) and sagittal (in 65 % of cases) planes were eliminated, the position of the lower jaw in the neuromuscular position (in 100 % of cases) was normalized. Conclusions. Treatment of patients with TMJ dysfunction using individual occlusal splints is one of the most effective ways to treat this pathology.
functional disorders, temporomandibular joint, kinesiography, occlusal splint, muscular-articular dysfunction
1. Kroshka, D. V., Dolgalev, A. A., Bragin, E. A., Yagmurov, M. A. (2017). Analiz rezul'tatov shinoterapii pri lechenii patsiyentov s disfunktsiyey visochno-nizhnechelyustnogo sustava i zhevatel'nykh myshts po dannym elektronnoy gnatografii [Analysis of the results of shinotherapy in the treatment of patients with dysfunction of the temporomandibular joint and masticatory muscles according to electronic gnatography]. Meditsinskiy vestnik Severnogo Kavkaza [Medical Bulletin of the North Caucasus], 12, 1, 65-68. doi:https://doi.org/10.14300/mnnc.2017.12019. (In Russ.)
2. Antonik, M. M., Kalinin, Yu. A. (2011). Primeneniye elektronnoy aksiografii dlya diagnostiki myshechno-sustavnoy disfunktsii u patsiyentov s patologiyey okklyuzii [Application of electronic axiography for the diagnosis of muscle and joint dysfunction in patients with occlusion pathology]. Stomatologiya [Dentistry], 90, 2, 23-27. (In Russ.)
3. Arsenina, O. I., Starikov, N. A., Gus, L. A. (2015). Rol' komp'yuternoy aksiografii v vyyavlenii disfunktsii visochno-nizhnechelyustnogo sustava razlichnoy stepeni tyazhesti u patsiyentov pri distal'noy okklyuzii zubnykh ryadov [The Role of computer axiography in detecting dysfunction of the temporomandibular joint of varying severity in patients with distal occlusion of the dentition]. Aktual'nyye problemy i perspektivy razvitiya stomatologii v usloviyakh severa: Sb. statey mezhregional'noy nauch. prakt. konf., posvyashchennoy 95-letiyu stomatologicheskoy sluzhby Respubliki Sakha (Yakutiya) [Actual problems and prospects for the development of dentistry in the North : Collection of articles of interregional scientific literature. prakt. Conf. dedicated to the 95th anniversary of the dental service of the Republic of Sakha (Yakutia)], North-Eastern Federal University M. K. Ammosova, 257-262. (In Russ.)
4. Naidanova, I. S., Pisarevsky, Yu. L., Shapovalov, A. G., Pisarevsky, I. Yu. (2018). Vozmozhnosti sovremennykh tekhnologiy v diagnostike funktsional'nykh narusheniy visochno-nizhnechelyustnogo sustava (obzor literatury) [Possibilities of modern technologies in the diagnosis of functional disorders of the temporomandibular joint (literature review)]. Problemy stomatologii [Actual problems in dentistry], 14, 4, 6-13. DOI.https://doi.org/10.18481/2077-7566-2018-14-4-6-13 (In Russ.)
5. Zhulev, E. N., Ershov, P. E., Ershova, O. A. (2017). Topograficheskaya anatomiya golovok nizhney chelyusti u patsiyentov s myshechno-sustavnoy disfunktsiyey visochno-nizhnechelyustnogo sustava i anomaliyami prikusa [Topographic anatomy of the lower jaw heads in patients with muscle-joint dysfunction of the temporomandibular joint and malocclusion abnormalities]. Vyatskiy meditsinskiy vestnik [Vyatka medical Bulletin], 3 (55), 96-99. (In Russ.)
6. Gerasimova, L. P., Yakupov, B. R. (2014). Elektromiograficheskoye issledovaniye funktsional'nogo sostoyaniya sobstvenno zhevatel'noy i visochnoy myshts pri myshechno-sustavnoy disfunktsii visochno-nizhnechelyustnogo sustava svyazannoy s okklyuzionnymi narusheniyami [Electromyographic study of the functional state of the chewing and temporal muscles proper in the case of muscular-articular dysfunction of the temporomandibular joint associated with occlusive disorders]. Vestnik rossiyskogo universiteta druzhby narodov [Bulletin of the Russian University of peoples ' friendship], 3, 77-81. (In Russ.)
7. Tarakanov, S. A., Podolsky, M. D., Trifonov, A. A., Ivanova, E. A. (2014). Diagnostika disfunktsiy visochno-nizhnechelyustnogo sustava [Diagnostics of dysfunction of the temporomandibular joint]. Stomatologiya dlya vsekh [Dentistry for all], 4, 16-18. (In Russ.)
8. Voronina, E. A., Nurieva, N. S., Vasiliev, Yu. S., Delets, A. V. (2018). Dislokatsii diska VNCHS kak sledstviye bokovogo smeshcheniya nizhney chelyusti [Dislocations of the TMJ disk as a result of lateral displacement of the lower jaw]. Problemy stomatologii [Actual problems in dentistry], 14, 4, 98-103. DOI.https://doi.org/10.18481/2077-7566-2018-14-4-98-103 (In Russ.)
9. Bugrovetskaya, O. G., Maksimova, E. A., Stetsyura, O. A., Kim, K. S. (2015). Differentsial'naya diagnostika razlichnykh tipov disfunktsii visochno-nizhnechelyustnogo sustava (kliniko-elektromiograficheskoye issledovaniye) [Differential diagnostics of various types of temporomandibular joint dysfunction (clinical and electromyographic study)]. Manual'naya terapiya [Manual therapy], 4, 10-19. (In Russ.)
10. Fadeev, R. A., Prozorova, N. V., Markasov, K. N. et al. (2017). Izucheniye funktsional'nogo sostoyaniya zhevatel'nogo apparata u patsiyentov s patologiyey tverdykh tkaney zubov nekarioznogo proiskhozhdeniya po dannym elektromiografii [Studying the functional state of the chewing apparatus in patients with pathology of hard tissues of teeth of non-carious origin according to electromyography]. Institut stomatologii [Institute of dentistry], 74, 41-43. (In Russ.)
11. Ibragimov, T. I., Stetsyura, O. A., Bugrovetskaya, E. A. et al. (2013). Klinicheskoye znacheniye elektromiograficheskikh kharakteristik razlichnykh tipov disfunktsii visochnonizhnechelyustnogo sustava [Clinical significance of electromyographic characteristics of various types of temporomandibular joint dysfunction]. Ortodontiya [Orthodontics], 4, 33-38. (In Russ.)
12. Klimova, T. V. (2010). Otsenka dvizheniy nizhney chelyusti u lits s fiziologicheskoy i distal'noy okklyuziyey metodom kineziografii : avtoreferat dis. ... kandidata meditsinskikh nauk [Assessment of the movements of the lower jaw in individuals with physiological and distal occlusion by kinesiography method: abstract of thesis. ... candidate of medical sciences]. Moscow, 26. (In Russ.)
13. Petrikas, I. V., Kurochkin, A. P., Trapeznikov, D. V. et al. (2018). Kompleksnyy podkhod k lecheniyu neyromuskulyarnogo disfunktsional'nogo sindroma VNCHS. Klinicheskoye nablyudeniye [A comprehensive approach to the treatment of neuromuscular dysfunctional TMJ syndrome. Clinical observation]. Problemy stomatologii [Actual problems in dentistry], 1, 66-70. doi:https://doi.org/10.18481/2077-7566-2018-000013. (In Russ.)
14. Lepilin, A. V., Konnov, A. V., Bagaryan, E. A. (2010). Klinicheskiye proyavleniya patologii visochno-nizhnechelyustnykh sustavov i zhevatel'nykh myshts u patsiyentov s narusheniyami okklyuzii zubov i zubnykh ryadov [Clinical manifestations of pathology of temporomandibular joints and masticatory muscles in patients with disorders of occlusion of teeth and dentition]. Saratovskiy nauchno-meditsinskiy zhurnal [Saratov scientific medical journal], 2, 405-410. (In Russ.)
15. Mishutin, E. A., Romanov, A. S., Karelin, A. N. (2015). Diagnostika sostoyaniya zhevatel'noy i visochnoy myshts s primeneniyem komp'yuternogo neyromiograficheskogo analizatora u lits s patologiyey visochno-nizhnechelyustnogo sustava [Diagnostics of the state of the chewing and temporal muscles using a computer neuromiographic analyzer in persons with pathology of the temporomandibular joint]. Meditsinskiy al'manakh [Medical almanac], 1, 37-38. (In Russ.)
16. Shelomentsev, E. V., Izatulin, V. G., Lebedinsky, V. Yu., Kondrashin, S. Yu. (2015). Osobennosti i vozmozhnosti prizhiznennogo izucheniya struktur visochno-nizhnechelyustnogo sustava [Features and possibilities of lifetime study of structures of the temporomandibular joint]. Sibirskiy meditsinskiy zhurnal (Irkutsk) [Siberian medical journal (Irkutsk)], 139, 8, 76-79. (In Russ.)
17. Silin, A. V., Sinitsina, T. M., Semeleva, E. I., Butova, A. V. (2015). Osobennosti morfologii lateral'nykh krylovidnykh myshts u patsiyentov s myshechno-sustavnoy disfunktsiyey visochno-nizhnechelyustnykh sustavov po dannym MRT [Features of the morphology of the lateral pterygoid muscles in patients with muscle-joint dysfunction of the temporomandibular joints according to MRI data]. Institut stomatologii [Institute of dentistry], 2, 44-45. (In Russ.)
18. Ronkin, K. A. (2015). Novyy protokol ispol'zovaniya elektromiografii i komp'yuternoy zapisi dvizheniya nizhney chelyusti [New Protocol for using electromyography and computer recording of lower jaw movement]. DentalMarket Journal [Dental Market Journal], 2, 73-84. (In Russ.)
19. Lazareva, O. V., Bimbas, E. S. (2018). Faktory dekompensatsii zubochelyustnoy sistemy u vzroslykh patsiyentov s glubokim reztsovym perekrytiyem [Factors of decompensation of the dentition system in adult patients with deep incisor overlap]. Problemy stomatologii [Actual problems in dentistry], 14, 4, 87-92. DOI.https://doi.org/10.18481/2077-7566-2018-14-4-87-92 (In Russ.)
20. Khudoroshkov, Yu. G., Ishmurzin, P. V. (2015). Okklyuzionnyye prediktory narusheniy artikulyatsii nizhney chelyusti pri disfunktsii visochno-nizhnechelyustnogo sustava [Occlusive predictors of lower jaw articulation disorders in temporomandibular joint dysfunction]. Institut stomatologii [Institute of dentistry], 2, 70-71. (In Russ.)
21. Jones, E. M., Papio, M., Tee, B. C., Beck, F. M., Fields, H. W., Sun, Z. (2016). Comparison of cone-beam computed tomography with multislice computed tomography in detection of small osseous condylar defects. American Journal of Orthodontics and Dentofacial Orthopedics, 150 (1), 130-139. doi:https://doi.org/10.1016/j.ajodo.2015.12.019.
22. Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., Svensson, P. (2014). 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. Journal of oral & facial pain and headache, 28 (1), 6. doi:https://doi.org/10.11607/jop.1151.
23. Slavicek, R. (2002). The Masticatory Organ: Functions and Dysfunctions. Klosterneuburg: Gamma Med. Fortbildung, 544.
24. Suenaga, S., Nagayama, K., Nagasawa, T., Indo, H., Majima, H. J. (2016). The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders. Japanese Dental Science Review, 52 (4), 93-106. doi:https://doi.org/10.1016/j.jdsr.2016.04.004.
25. Qadeer, S., Abbas, A. A., Sarinnaphakorn, L., & Kerstein, R. B. (2018). Comparison of excursive occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III. CRANIO®, 36 (1), 11-18. doi:https://doi.org/10.1080/08869634.2015.1122277.
