Actual problems in dentistry Actual problems in dentistry Проблемы стоматологии 2077-7566 2412-9461 115447 10.18481/2077-7566-2026-22-2-210-215 ОРТОПЕДИЧЕСКАЯ И ЦИФРОВАЯ СТОМАТОЛОГИЯ. ОБЗОРЫ ЛИТЕРАТУРЫ ORTHOPEDIC AND DIGITAL DENTISTRY. REVIEWS ОРТОПЕДИЧЕСКАЯ И ЦИФРОВАЯ СТОМАТОЛОГИЯ. ОБЗОРЫ ЛИТЕРАТУРЫ A COMPLEX APPROACH TO THE DIAGNOSIS AND TREATMENT OF TMJ DYSFUNCTION: RATIONALE FOR THE INCLUSION POSTUROLOGICAL SCREENING КОМПЛЕКСНЫЙ ПОДХОД К ДИАГНОСТИКЕ И ЛЕЧЕНИЮ ДИСФУНКЦИИ ВНЧС: ОБОСНОВАНИЕ ВКЛЮЧЕНИЯ ПОСТУРОЛОГИЧЕСКОГО СКРИНИНГА Дубова Любовь Валерьевна Dubova Lyubov V. dubova.l@gmail.com

доктор медицинских наук;

doctor of medical sciences;

 Минатуллаев Расул Арсаналиевич Minatullaev Rasul A. rasul.25032000@mail.ru Маджидова Елизавета Руслановна Madjidova Elizaveta R. Madzhidova@mail.ru

кандидат медицинских наук;

candidate of medical sciences;

 https://orcid.org/0000-0003-3507-6825 Романкова Наталья Владимировна Romankova Natalia V. n.v.romankova@gmail.com

кандидат медицинских наук;

candidate of medical sciences;

 Харченко Дмитрий Андреевич Kharchenko Dmitry A. dr.kharchenko@gmail.com

кандидат медицинских наук;

candidate of medical sciences;

 Российский университет медицины Москва Россия Russian University of Medicine Moscow Russian Federation Московский государственный медико-стоматологический университет имени А.И. Евдокимова Moscow State University of Medicine and Dentistry Московский государственный медико-стоматологический университет имени А. И. Евдокимова Москва Россия Peoples' Friendship University of Russia Moscow Russian Federation МГМСУ им. А.И. Евдокимова Москва Россия A.I. Yevdokimov MSMSU Moscow Russian Federation Российский университет медицины Москва Россия Russian University of Medicine Moscow Russian Federation 29 06 2026 29 06 2026 22 2 210 215 20 02 2026 https://dental-press.ru/en/nauka/article/115447/view

Актуальность. В современной стоматологии отмечается устойчивый рост числа пациентов с дисфункцией височно-нижнечелюстного сустава (дВНЧС), что требует развития комплексного подхода, рассматривающего стоматогнатическую систему как часть опорно-двигательного аппарата. Несмотря на данные о связи окклюзии и постурального баланса, стандартные диагностические алгоритмы часто не включают объективные методы оценки этой взаимосвязи. Цель. На основании анализа современных литературных данных обосновать необходимость включения постурологического и стабилометрического скрининга в диагностический протокол пациентов с дВНЧС для повышения эффективности и стабильности реабилитации. Материалы и методы. Проведен аналитический обзор источников, отобранных в базах PubMed, Scopus, Web of Science, eLIBRARY, Cyberleninka за период 2015–2025 гг. по ключевым словам, связанным с дисфункцией ВНЧС, окклюзией, постурологией и стабилометрией. В окончательную выборку вошли 26 релевантных публикаций. Результаты. Анализ литературы подтвердил наличие нейрофизиологической и биомеханической связи между окклюзией, состоянием ВНЧС и постуральным контролем. Показано, что различные положения нижней челюсти статистически значимо влияют на постуральный баланс. Выявлены основные механизмы связи: нарушение проприоцептивной афферентации от тригеминальной системы и изменение активности мышечных цепей. Исследования демонстрируют, что у пациентов с дВНЧС параметры постуральной устойчивости достоверно ниже, а характер их изменений при смыкании зубов зависит от типа нарушений. Выводы. Включение стабилометрии в комплексный диагностический протокол дВНЧС предоставляет объективный критерий эффективности лечения. Улучшение стабилометрических показателей после применения окклюзионно-стабилизирующего аппарата свидетельствует о нормализации функции ВНЧС и положительном воздействии на общий постуральный баланс.

Relevance. Modern dentistry is witnessing a steady increase in the number of patients with temporomandibular joint dysfunction (TMD), necessitating the development of a comprehensive approach that considers the stomatognathic system as part of the musculoskeletal system. Despite data on the relationship between occlusion and postural balance, standard diagnostic algorithms often lack objective methods to assess this relationship. Aim. Based on an analysis of current literature, to substantiate the necessity of including posturological and stabilometric screening in the diagnostic protocol for patients with TMD to improve the effectiveness and stability of rehabilitation. Materials and methods. An analytical review of sources selected from PubMed, Scopus, Web of Science, eLIBRARY, and Cyberleninka databases for the period 2015–2025 was conducted using keywords related to TMD, occlusion, posturology, and stabilometry. The final selection included 26 relevant publications. Results. The literature analysis confirmed the existence of a neurophysiological and biomechanical relationship between occlusion, TMJ status, and postural control. It was shown that various mandibular positions have a statistically significant effect on postural balance. Key mechanisms of this relationship were identified: disrupted proprioceptive afferent input from the trigeminal system and changes in muscle chain activity. Studies demonstrate that patients with TMD have significantly lower postural stability parameters, and the nature of their changes during teeth clenching depends on the type of disorder. Conclusion. The inclusion of stabilometry in the comprehensive diagnostic protocol for TMD provides an objective criterion for treatment effectiveness. Improvement in stabilometric parameters after using an occlusal stabilization appliance indicates normalization of TMJ function and improved overall postural balance.

 ортопедическая стоматология дисфункция ВНЧС окклюзия постурология стабилометрия orthopedic dentistry temporomandibular dysfunction occlusion posturology stabilometry

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