Ekaterinburg, Ekaterinburg, Russian Federation
Ekaterinburg, Ekaterinburg, Russian Federation
Subject. Anomalies of the dentition and deformities of the dentition in adult patients are often accompanied by disorders in the temporomandibular joint (TMJ). At present, the possibilities of diagnosing TMJ diseases have increased significantly due to the emergence and use of modern instrumental and technical methods. However, data on the optimal choice of research methods, their scope and sequence of execution in patients with TMJ diseases are not presented in the literature. The treatment of patients with dentoalveolar anomalies (DA), combined with functional disorders of the TMJ, according to many authors, presents significant difficulties. Currently, the problem of effective diagnosis of patients with AF and functional disorders of the TMJ remains an urgent problem in dentistry. The aim of the study to develop a method for diagnosing patients with AF and functional disorders of the TMJ based on the method of M. Helkimo. Methodology. Questioning and clinical examination of 150 patients aged 18–44 years with dentoalveolar anomalies and symptoms of temporomandibular joint dysfunction were carried out. According to the proposed diagnostic method, signs of TMJ dysfunction were determined: articular, muscular, neurological and occlusive. When identifying occlusal and muscle signs of dysfunction, an in-depth study was carried out according to the proposed scheme. Results. Own observations and studies have shown that the system of signs of dysfunction of the temporomandibular joint can be used as a scheme for the initial examination of a patient with dento-maxillary anomalies and functional disorders of the TMJ at the dentist's appointment. Conclusions. The proposed diagnostic method allows the dentist at the initial appointment, without using additional instrumental diagnostic methods, to determine the amount of necessary research for patients with dento-maxillary anomalies and functional disorders of the TMJ.
functional disorders, temporomandibular joint, occlusion, parafunction of the masticatory muscles, dentoalveolar anomalies
1. Bezrukov V.M., Semkin V.A., Grigor'yanc L.A., Rabuhina N.A. Zabolevaniya visochno-nizhnechelyustnogo sustava. Uchebnoe posobie. Moskva : GEOTAR-MED. 2002:48. [V.M. Bezrukov, V.A. Semkin, L.A. Grigoryants, N.A. Rabukhina. Diseases of the temporomandibular joint. Textbook. Moscow : GEOTAR-MED. 2002:48. (In Russ.)]. https://www.combook.ru/product/272097/
2. Bragin E.A., Dolgalev A.A., Bragareva N.V. Rol' okklyuzionnyh narusheniy v razvitii zabolevaniy visochno-nizhnechelyustnogo sustava, disfunkciy zhevatel'nyh myshc i zabolevaniy parodonta. Nauchnoe obozrenie. Medicinskie nauki. 2015;1:90-91. [E.A. Bragin, A.A. Dolgalev, N.V. Bragareva. The role of occlusal disorders in the development of diseases of the temporomandibular joint, masticatory muscle dysfunctions and periodontal diseases. Scientific Review. Medical Sciences. 2015;1:90-91. (In Russ.)]. https://science-medicine.ru/ru/article/view?id=656
3. Vyaz'min A.Ya., Puzin M.N. Bolevaya disfunkciya visochnonizhnechelyustnogo sustava. Moskva : Medicina. 2002;160. [A.Ya. Vyazmin, M.N. Puzin. Pain dysfunction of the temporomandibular joint. Mjscow : Medicine. 2002;160. (In Russ.)]. https://kingmed.info/knigi/Stomatologiya/Obshchaya_stomatologiya/book_2927/Bolevaya_disfunktsiya_visochno-nijnechelyustnogo_sustava-Puzin_MN_Vyazmin_AYa-2002-djvu
4. Douson P.E. Funkcional'naya okklyuziya: ot visochno-nizhnechelyustnogo sustava do planirovaniya ulybki. Moskva : Prakticheskaya medicina. 2016:592. [P.E. Dawson. Functional occlusion: from the temporomandibular joint to smile planning. Moscow : Practical medicine. 2016:592. (In Russ.)]. https://www.labirint.ru/books/529095/
5. Ivanichev G.A. Miofascial'naya bol': monografiya. Kazan' : Izd-vo Kazan' GMA. 2007:392. [G.A. Ivanichev. Myofascial pain: monograph. Kazan : Publishing House Kazan GMA. 2007:392. (In Russ.)]. https://infamed.com/mfp/
6. Ivasenko P.I., Savchenko R.K., Miskevich M.I., Fel'ker V.V. Zabolevaniya visochno-nizhnechelyustnogo sustava. Moskva : Medicinskaya kniga. 2009:116. [P.I. Ivasenko, R.K. Savchenko, M.I. Miskevich, V.V. Felker. Diseases of the temporomandibular joint. Moscow : Medical book. 2009:116. (In Russ.)]. https://polymedbook.ru/shop/otorinolaringologija/zabolevanija-visochno-nizhnecheljustnogo/
7. Kozlov D.L., Vyaz'min A.Ya. Etiologiya i patogenez sindroma disfunkcii visochno-nizhnechelyustnogo sustava. Sibirskiy medicinskiy zhurnal. 2007;4:5-7. [D.L. Kozlov, A.Ya. Vyazmin. Etiology and pathogenesis of temporomandibular joint dysfunction syndrome // Siberian Medical Journal. 2007;4:5-7. (In Russ.)]. https://www.elibrary.ru/item.asp?id=18052917
8. Petrikas I.V., Zhirkov A.M., Krasnov A.A. Kompleksnyy mezhdisciplinarnyy podhod k profilaktike i lecheniyu disfunkcii VNChS. Problemy stomatologii. 2016;1:97-102. [I.V. Petrikas, A.M. Zhirkov, A.A. Krasnov. A comprehensive interdisciplinary approach to the prevention and treatment of TMJ dysfunction. Actual problems in dentistry. 2016;1:97-102. (In Russ.)]. https://www.elibrary.ru/item.asp?id=25781411
9. Postnikov M.A., Nesterov A.M., Trunin D.A. i dr. Vozmozhnosti diagnostiki i kompleksnogo lecheniya pacientov s disfunkciyami visochno-nizhnechelyustnogo sustava. Klinicheskaya stomatologiya. 2020;1:60-63. [M.A. Postnikov, A.M. Nesterov, D.A. Trunin. Possibilities of diagnostics and complex treatment of patients with dysfunctions of the temporomandibular joint. Clinical dentistry. 2020;1:60-63. (In Russ.)]. https://www.elibrary.ru/item.asp?id=42846269
10. Semkin V.A., Rabuhina N.A. Disfunkciya visochno-nizhnechelyustnyh sustavov. Moskva. 2000:53. [V.A. Semkin, N.A. Rabukhina. Dysfunction of the temporomandibular joints. Moscow. 2000:53. (In Russ.)]. https://kingmed.info/metodicheskie-rekomendatsii/Stomatologiya/Obshchaya_stomatologiya/recommendation_853/Disfunktsiya_visochno-nijnechelyustnih_sustavov_klinika_diagnostika_i_lechenie
11. Silin A.V., Satygo E.A., Semeleva E.I. Poverhnostnaya elektromiografiya visochnyh i sobstvenno zhevatel'nyh myshc v diagnostike visochnonizhnechelyustnyh sustavov. Klinicheskaya Stomatologiya. 2013;2:22-24. [A.V. Silin, E.A. Satygo, E.I. Semeleva. Surface electromyography of the temporal and masticatory muscles proper in the diagnosis of temporomandibular joints. Clinical Dentistry. 2013;2:22-24. (In Russ.)]. https://www.elibrary.ru/item.asp?id=22474109
12. Sysolyatin P.G., Il'in A.A., Dergilev A.P. Klassifikaciya zabolevaniy i povrezhdeniy visochno-nizhnechelyustnogo sustava. Moskva : Medicinskaya kniga ; N.Novgorod : Iz-vo NGMA. 2001:77. [P.G. Sysolyatin, A.A. Ilyin, A.P. Dergilev. Classification of diseases and injuries of the temporomandibular joint. Moscow : Medical book ; N.Novgorod : From NGMA. 2001:77. (In Russ.)]. https://search.rsl.ru/ru/record/01000726550
13. Trezubov V.N. Bulycheva E.A., Bystrova V.V., Gorbachѐv V.V. Rol' biologicheskoy adaptivnoy svyazi v kompleksnom patogeneticheskom lechenii zabolevaniy visochno-nizhnechelyustnogo sustava i zhevatel'nyh myshc. Institut stomatologii. 2003;3:33-35. [V.N. Trezubov, E.A. Bulycheva, V.V. Bystrova, V.V. Gorbachev. The role of biological adaptive communication in the complex pathogenetic treatment of diseases of the temporomandibular joint and masticatory muscles. Institute of Dentistry. 2003;3:33-35. (In Russ.)]. https://instom.spb.ru/catalog/article/8448/
14. Fisenko Yu.N. Aspekty ortodonticheskogo lecheniya zabolevaniy visochno-nizhnechelyustnogo sustava. [Yu.N. Fisenko, N.M. Medvedovskaya. Aspects of orthodontic treatment of diseases of the temporomandibular joint. (In Russ.)]. https://elibrary.ru/item.asp?id=44929407
15. Hvatova V.A. Gnatologicheskie principy v diagnostike i lechenii patologii zubochelyustno-licevoy sistemy. Novoe v stomatologii. 2001;1:96. [V.A. Khvatova. Gnathological principles in the diagnosis and treatment of pathology of the dentofacial system. New in dentistry. 2001;1:96. (In Russ.)]. https://www.studmed.ru/hvatova-va-klinicheskaya-gnatologiya_8cac821be22.html
16. Cimbalistov A.V., Lopushanskaya T.A., Hudonogova E.A., Voytyackaya I.V., Chervotok E.A. Dinamika stabilometricheskih harakteristik na etapah ortodonticheskogo lecheniya distal'noy okklyuzii u bol'nyh s narusheniyami oporno-dvigatel'nogo apparata. Ortodontiya. 2005;3:21-24. [A.V. Tsimbalistov, T.A. Lopushanskaya, E.A. Khudonogova, I.V. Voityatskaya, E.A. Chervotok. Dynamics of stabilometric characteristics at the stages of orthodontic treatment of distal occlusion in patients with disorders of the musculoskeletal system. Orthodontics. 2005;3:21-24. (In Russ.)]. https://instom.spb.ru/catalog/article/10206/
17. Cimbalistov, A.V. Lopushanskaya T.A. Diagnosticheskie kriterii sindroma bolevoy disfunkcii visochno-nizhnechelyustnogo sustava. Klin. Stomatol. 2014;3:26-27. [A.V. Tsimbalistov, T.A. Lopushanskaya. Diagnostic criteria for the syndrome of pain dysfunction of the temporomandibular joint. Clinical Dentistry. 2014;3:26-27. (In Russ.)]. https://umedp.ru/articles/miofastsialnyy_bolevoy_sindrom_problemy_diagnostiki_i_lecheniya.html
18. Manfredini D., Marini M., Pavan C., Pavan L., Guarda-Nardini L. Psychosocial profiles of painful TMD patients // J. Oral Rehabil. - 2009;36(3):193-198. doi:https://doi.org/10.1111/j.1365-2842.2008.01926.x.
19. Okeson Jeffrey P. Management of Temporomandibular Disorders and Occlusion // Mosby. - 2020;8:512. https://www.elsevier.com/books/management-of-temporomandibular-disorders-and-occlusion/okeson/978-0-323-58210-0
20. Schupp W., Marx G. Treatment of craniomandibular dysfunction by means of manual manipulation of the temporomandibular joints // Manuelle Medizin. - 2002;40(3):177-183. http://journal-archiveuromedica.eu/archiv-euromedica-01-2021/archiv_euromedica_01_2021_maket_27_03_2021_26.pdf
21. Slavicek R. The Masticatory Organ: Functions and Dysfunctions. Klosterneuburg : Gamma Med.-viss. FortbildungAG. 2002:544. https://www.worldcat.org/title/54107195
22. Whyte A.M., McNamara D., Rosenberg I., Whyte A.W. Magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement - a review of 144 cases // J. Oral. Maxillofac. Surg. - 2006;35:696-703. doi:https://doi.org/10.1016/j.ijom.2005.12.005.
23. Wieckiewicz M., Boening K., Wiland P., Shiau Y.Y., Paradowska Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders // Journal of Headache and Pain. - 2015;16(106):1-12. DOIhttps://doi.org/10.1186/s10194-015-0586-5
24. Wilkes C.H. Internal derangements of the temporomandibular joint: pathological variations // Archives of Otolaryngology-Head & Neck Surgery. - 1989;115(4):469-477. DOIhttps://doi.org/10.1001/archotol.1989.01860280067019
25. Yalcin E.D., Ararat E. Cone-Beam Computed Tomography Study of Mandibular Condylar Morphology // J Craniofac Surg. - 2019;30(8):2621-2624. https://pubmed.ncbi.nlm.nih.gov/31261335/
