The aim: To study the consequences of temporomandibular joint injury and efficacy of arthrocentesis for treatment of post-traumatic internal temporoman¬dibular disorders. Materials and methods: 24 patients who experienced trauma history in the head without jaw fractures underwent CT, ultrasound and/or MRI. TMJ ar¬throcentesis was performed according to a modified method of D. Nitzan (1991) under local anesthesia by means of blockade of the peripheral branch of the auricular-temporal nerve on the background of intravenous sedation. Results: The ages of the patients varied between 18 and 44 years, and mean was 32,58 years. The causes of trauma were diverse, as traffic accident – 3 (12,5%), assault 12 (50%), hit by materials 3 (12, 5%), and fall-down 6 (25%). According to clinical and radiological signs after traumatic temporomandibular disorders, patients were divided into two groups according to Wilkes classification (1989): 13 patients with stage II (early-middle) and 11 - with stage III (middle).The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 84.61% of patients with intra-articular disorders of the second degree, and in 72.72% of patients with internal disorders of the third degree, the position and function of the articular disc was restored. Conclusions: Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has proven itself in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible.
Aim: Improving the quality of diagnosis and treatment orthodontic pathology in patient with temporomandibular joint disorders. Materials and Methods: Analysis – to determine objectives and study plan; clinical-diagnostic methods that include dental and radiological examination (to establish the clinical diagnosis of patients with temporomandibular disorders), electronic axiography (to determine the features of the movements of the articular heads of the mandible), instrumental study the models of jaws in the articulator (to diagnose the state of functional occlusion), statistical (to calculate averages and assess the probability of the results). Results: After developed and implemented algorithm total dental rehabilitation we have eliminated functional disorders in the masticatory muscles and temporomandibular joints, completely restored the lost function of the masticatory apparatus. Conclusions: Creation of occlusal relations, which are harmoniously combined with the function of masticatory muscles and temporomandibular joints, allowed to achieve the long period of remission, absence of the complications and recurrences of the disease in the near and long term. These points became the criterions that improved effectiveness of scientifically based individual treatment of mandibular disorders.
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