PATHOLOGY OF OCCLUSION AS A FACTOR IN THE DEVELOPMENT OF MUSCULO-ARTICULAR DISORDERS. DIAGNOSIS AND EFFICIENCY OF TREATMENT
Journal Title: World Science - Year 2018, Vol 4, Issue 4
Abstract
Introduction. Disturbance of occlusal relationships and functional occlusion, parafunctions of masticatory muscles play an important role in the pathogenesis of muscular temporomandibular disorders. A prerequisite for the development of muscle disorders is the presence of pathology of occlusion, which leads to disturbance of balanced occlusion and articulation and muscle balance, spatial orientation of the mandible in relation to the maxilla. Purpose. Analysis of the state of dentofacial system in patients with muscular temporomandibular disorders and approaches and results of their treatment. Materials and methods. The objects of the study were 45 patients with muscular temporomandibular disorders combined with different types of pathology of occlusion before and after complex treatment. Patients underwent clinical examination of dentofacial system, functional status of masticatory muscles and temporomandibular joint. Treatment of patients was conducted by applying occlusal therapy in the centric jaw relation, orthodontic treatment, correction and reconstruction of occlusion with orthopaedic approaches. Treatment efficacy was determined by comparing the clinical data and axiogram parameters before and after treatment. Results. It was determined that muscular temporomandibular disorders in all patients under study were related to different nosological entities of dentofacial pathologies with the prevalence of orthodontic pathology (54.5 %) and abnormal eruption of third molars (20.4 %) at the age of 23 to 30. Other pathologies of these patients were specific to more advanced age. Iatrogenic pathology as a result of inadequate dental care was detected in 9.1 % of patients. According to the analysis of axiograms before and after treatment of patients with muscle disorders, statistically confirmed improvement of mandibular head movements was defined by all parameters confirming the positive results of the chosen treatment. Conclusions. Treatment of patients with muscular temporomandibular disorders should be individualized and include occlusal therapy intended to normalize functional occlusion of the centric jaw relationship. Orthodontic treatment and correction or reconstruction of occlusion by orthopaedic approaches should be performed if clinically indicated.
Authors and Affiliations
Yuriy Rybert, Taras Pupin, Natalia Mahera
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