Occlusive Therapy of Temporomandibular Disorders

Chkhikvadze, T V; Бекреев, В. В.

doi:10.22363/2313-0245-2018-22-4-387-401

Vestn. Ross. univ. družby nar., Ser. Med.

2018

DOI: 10.22363/2313-0245-2018-22-4-387-401

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Occlusive Therapy of Temporomandibular Disorders

T V Chkhikvadze

В. В. Бекреев

Abstract: В работе представлен анализ исследований ряда отечественных и зарубежных авторов, посвященных изучению различных окклюзионных капп, в частности, механизмам их действия, классификации, их эффективности при различных формах поражения височно-нижнечелюстного сустава (ВНЧС), преимуществах и недостатках отдельных капп, а также материалов, используемых при их изготовлении. Как показал анализ представленных научных работ, использование окклюзионных капп в комплексном лечении нарушений функции ВНЧС позволяет достичь н… Show more

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Cited by 6 publications

References 32 publications

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Registration of jaw centric relation with different deprogramming devices

Privalova,

Leshcheva

2024

HERALD of North-Western State Medical University named after I.

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BACKGROUND: There are several methods to register jaw centric relation for diagnosis and therapy of dysfunctional disorders of the temporomandibular joint. However, there is insufficient information in the literature regarding the choice of the optimal way to determine this indicator. AIM: To compare different methods for recording jaw centric relation according to the data of the computed tomography of temporomandibular joint. MATERIALS AND METHODS: The study includes participants with increased abrasion of hard tooth tissues and symptoms of musculoskeletal dysfunction of the temporomandibular joint. The main group (80 people) has been recorded jaw centric relation using deprogramming devices (Lucia jig — 1stsubgroup, Kois deprogrammer — 2ndsubgroup, sheet calibrator — 3rd subgroup, deprogrammer in combination with M. Rocаbado kinesiotherapy elements — 4th subgroup). The control group included 20 participants, who had not had deprogramming before registration of jaw centric relation. The results were monitored using computed tomography of temporomandibular joint and subsequent assessment of the sizes of the TMG articular gap in the coronary and sagittal sections at 3 stages of the study: diagnostic, after registration of jaws central relation and prosthetic treatment and 6 months after prosthetic rehabilitation. Since there were no more than 50 observations in each group, the Shapiro–Wilk W-test was used to verify compliance with the norm. RESULTS: According to the data obtained, the parameters of the temporomandibular joint gap have changed in the main group of the 1th subgroup, where indicators are approaching the physiological norm (98% of cases). In the 2ndsubgroup, 90% of the participants show a tendency to conform to the physiological norm. The exception is 10% of the participants with no tendency of improvement. The smaller part (75%) of the participants of the 3rd subgroup observed compliance of the parameters of the articular gap with the criteria of the norm. The dimensions of the anterior part of the articular gap of the temporomandibular joint exceed the dimensions of the distal part, which indicates the anterior position of the temporomandibular joint. Some patients in this group (25%) showed no positive results of computed tomography measurements after jaws centric relation registration. In the 4th subgroup, the patients returned to normal values (100% of the cases). The positive effect of prosthetic treatment and restoration of the position of the articular heads of the temporomandibular joint were obtained in 45 % of the participants in the control group. However, in 55% of the participants the location of the articular gap of the temporomandibular joint did not improve. CONCLUSIONS: Lucia jig in combination with the M. Rokabado’s complex of cranial-postural kinesiotherapy is the most effective method to register jaw centric relation within this study. The remaining methods are also applied among prosthetic dentists and gnathologists. However, in each clinical situation, it is necessary to consider temporomandibular joint pathology indications, type and degree of severity as well as the technical and financial capacity of both doctor and patient.

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Registration of jaw centric relation with different deprogramming devices

Privalova,

Leshcheva

2024

HERALD of North-Western State Medical University named after I.

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Analysis of hardware methods of treatment of patients with temporomandibular joint dysfunction

Dolgalev,

Khristoforando,

Garus

et al. 2024

Perm Medical Journal

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Objective. To conduct a comparative analysis of effectiveness of treatment of patients with dysfunction of temporomandibular joint (DTMJ) using hardware methods of treatment with occlusive mouthguards of various types. Materials and methods. 99 patients (88 females and 11 males aged 41,2 ± 10,7) with different combinations of revealed and confirmed signs of DTMJ were examined from 2013 to 2023. According to the personal clinical picture, complaints revealed, aetiology and pathogenesis of the disease all the patients of the comparison group and 2 main groups (99 patients) were administered individual complex treatment for DTMJ. The treatment was aimed at the elimination of pain, relief of masticatory muscles spasm, improvement of the extent of opening of mouth, correction of the lower jaw position, occlusive interference elimination and restoration of height of the lower third of the face. While carrying out the hardware treatment, occlusive mouthguards of 3 types were made based on the jaw model of the patients. The models were got from the silicone imprints of the jaw. Results. MR images of temporomandibular joints of the 99 patients showed that ventral dislocation of articular disk occurred most frequently (in 88 patients). Less frequently (4 % of cases) it was combined with dislocation of the disk laterally. Rarely distal dislocation of the articular disk occurred – 1,9 % of cases (2 patients). Study of the results of the appliance of different types of occlusive mouthguards demonstrates the necessity to work out the types of occlusive devices allowing decompression of temporomandibular joint elements, centering lower jaw position and orthodontic elimination of dentofacial abnormalities and deformities which lead to occlusive interference. Conclusions. Analysis of occlusive devices used in the diagnosis and treatment of patients with DTMJ shows that the most effective devices are those that successfully combine elements of splints with a narrower purpose.

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Copyright Research Protocol for Comprehensive Assessment of the Dento-Alveolar Complex in Patients with Temporomandibular Joint Disorders: Clinical Cases

Tekucheva,

Bazikyan,

Afanasyeva

et al. 2023

Kuban. nauсh. med. vestnik

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Background. Currently, the issues of diagnosis and treatment of patients with dentoalveolar injuries combined with temporomandibular joint disorders are highly relevant due to a progressive increase in the number of cases of this pathology among the population. Despite the availability of the comprehensive methodology in diagnostics of dentoalveolar injuries, dentists lack standardized algorithms for effective examination and systematization of the data obtained in the diagnostics of such groups of patients, which is necessary for personalized planning and pathogenetic therapy. The authors present the algorithm they developed for comprehensive assessment of dentoalveolar injuries in patients with temporomandibular joint disorders.Case descriptions. The paper presents clinical cases of two patients with abnormal occlusion associated with temporomandibular joint disorder. The patients underwent a comprehensive morphofunctional examination of the dentoalveolar complex in accordance with the diagnostic algorithm patented by the authors, including following methods: clinical (interview, examination), anthropometric (anthropometry of dentition), radiological (cone-beam computed tomography, magnetic resonance imaging of the temporomandibular joint), functional (surface electromyography of the masticatory muscles, computer kinesiography, electro-vibrography, ultrasound examination of the temporomandibular joint), to make the final diagnosis and to determine the order and scope of treatment.Conclusion. The authors presented and proved clinically the algorithm of morphofunctional diagnostics for the dento-alveolar complex of patients with temporomandibular joint disorders, combining clinical, anthropometric, radiological and functional methods of examination, which allow the most dento-alveolar characteristics to be considered in order to make the main diagnosis and a personalized treatment protocol for such groups of patients

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Occlusive Therapy of Temporomandibular Disorders

Cited by 6 publications

References 32 publications

Registration of jaw centric relation with different deprogramming devices

Registration of jaw centric relation with different deprogramming devices

Analysis of hardware methods of treatment of patients with temporomandibular joint dysfunction

Copyright Research Protocol for Comprehensive Assessment of the Dento-Alveolar Complex in Patients with Temporomandibular Joint Disorders: Clinical Cases

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