Introduction. Meniscus displacement in the temporomandibular joint (TMJ) is known to provoke the development of TMJ dysfunction, thereby impairing the quality of life. Managing TMJ disorders is divided into three stages, the first of which is intermediate in determining the prognosis and further tactics. The aim of the study is to evaluate the effectiveness of occlusal splint systems and to assess the different stages of TMJ dysfunction management. Materials and methods. The study included 54 patients. Based on the findings of magnetic resonance imaging, patients were divided into two groups: group I included patients with dysfunctional changes in the TMJ (n=38), group II involved patients with dysfunctional changes in the joints and concomitant osteoarthritic changes (n=16). Results and discussion. The first stage of treatment was carried out using a Michigan occlusal splint. During this time, the myotatic reflex was restructured and clinical symptoms of the TMJ disorder disappeared. The treatment outcomes were as follows: the subjects of the 1st group reported about health improvement in a month since the treatment started, 20 individuals out of 38 patients had no symptoms of TMJ dysfunction. The treatment course of these patients was completed. The other 18 patients were referred for the orthodontic treatment. After the end of the splint treatment, no longer than in 2 weeks, the patients of the II group reported bout the recurrence of some symptoms that indicated a relapse of the disease; therefore, patients were recommended to continue the treatment. In the second stage of the treatment, we used occlusal plates on the lower unprepared teeth. At the third stage of treatment, radical prosthetics was carried out, which includes temporary fixation of polymethyl methacrylate prototypes on specially prepared teeth, and then the final fixation of permanent structures in the new medical condition of the lower jaw. Conclusion. Bite-sized intraoral guards that allow mesialisation of the lower jaw and increase the height of the bite, in particular, the Michigan occlusal splint have been found as effective appliances. Patients who had only dysfunctional TMJ changes (group I) over the course of treatment need only restructuring of the myotonic reflex, rather than those who suffer from osteoarthritic changes (group II), and therefore should undergo radical orthopaedic treatment.
Introduction. Dysfunction of the temporomandibular joint is a rather widespread disorder and occupies a leading place among all other joint disorders. Subjects and methods. The study was conducted at the Department of Propaedeutics of Surgical Dentistry. 10 people with clinical signs of temporomandibular joint (TMJ) dysfunction were selected, and subjected to radiological and magnetic resonance imaging in order to clarify the final diagnosis. Results and discussion. The main criterion for magnetic resonance imaging diagnostics in dysfunctional TMJ conditions is visualization of the intra-articular cartilage disc. When comparing radiograms and magnetic resonance imaging, the main criteria were: Distortion between research methods; The presence of any bone formation and its importance in making a diagnosis. Comparing the series of radiograms and magnetic resonance imagings shows the distortion of the imaging results. In four patients, radiograms showed narrowing of the joint space in the anterior-posterior sections, but this did not occur on magnetic resonance imaging. In this case, patients should feel pain irradiating to the ear. This option is possible due to compression of the bilaminar zone, where the auriculotemporal nerve is located. Characteristic pathological symptoms were determined in one patient out of four that prompts the question about the correctness of determining the joint space on a series of radiograms. In these research methods, the following features were common: 1. The articular head was flattened (4 patients), had a dumbbell-like shape (6 patients). 2. With the mouth open, attention was drawn to the placement of the articular head in relation to the articular tubercle. Subluxation of one of the joints was found 8 patients; joint hypermobility was detected in 2 patients. Magnetic resonance imaging of the TMJ joint in 3 patients showed anatomical instability, namely degenerative changes in the articular discs, and bony growths. Degenerative changes of the meniscus did not occur in the other 7 patients. Conclusion. Undoubtedly, the best diagnosis when choosing the right method is based on the doctor's experience in correct image interpreting. Radiogram is a relatively cheap method compared to magnetic resonance imaging, but it is far from being exceptionally effective because it does not visualize the connective tissue elements of the joint. Magnetic resonance imaging fully characterizes all bone and soft tissue elements that helps the doctor to clearly determine the final diagnosis based on which the treatment plan will be made up.
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