Optimization of diagnostics and treatment of temporal-mandibular impairments

One of the most common pathologies among lesions dentition is dysfunction of the temporomandibular joint (TMJ). According to literature, 70 to 100% of the population suffer from TMJ pathology. The increasing number of patients with TMJ pathology can be explained by improved diagnosis and increased paraclinical methods, especially by the technical capabilities of medical research. Under our supervision there were 86 patients with various disorders of TMJ dysfunction. Anamnesis data revealed that the patients earlier underwent dental treatment for caries and its complications. Comparison group consisted of 15 people with full dental health and orthognatic bite. One of the assigned tasks was to study the influence of the seal teeth on TMJ. In terms of limitations to seal the teeth of patients in the main group, 26 patients were observed up to 1 year, 32 patients - up to 2 and 28 patients - up to 3 years. Characteristics of sealed teeth of upper and lower jaws were as follows: front - 19 (incisors and cuspids), premolars and molars - 77. Revealed that 85% patients of main group in the first days of the sealing had pain when biting and food intake, and at the 20-30 days - crepitation, clicking and noise in the area of TMJ. Assessment of occlusal relations of the teeth and dentition were determined using wax occlusal and copy paper, with subsequent removal of the casts of both jaws. The models placed into the articulator and received data were recorded in designed “Personal data sheet” of TMJ. Establishing the causes, acute or chronic changes of occlusal relationships (supercontext) should be considered as a fundamental trigger in the pathogenesis of TMJ dysfunction as well as forced position the lower jaw with formation of pathological conditions. In this aspect main role should be given to mistakes and complications during recovery and teeth filling that can cause the dysfunction of TMJ, periodontosis etc. When planning therapeutic interventions in case of TMJ dysfunction clinical and radiographic evaluation, orthopantomography, computed tomography, functional methods of investigation (electronography), and the elimination of the causes leading to its development (occlusal relation of the jaws) are necessary that will greatly enhance the capabilities of diagnosis and treatment.

tooth filling, parodontitis, malocclusion, dysfunction of the temporal-mandibular joint