Altered mandibular dynamics between bruxism and temporomandibular joint dysfunction

Abstract

Introduction. The face and its associated structures (cranial, oral, dental) form one of the most complex areas of the human body, hence the diversity of the anatomical and functional pathologies at this level. Sometimes, the approach from the perspective of only one medical specialization may lead to symptomatology improvement or even remittance, but there are many situations when relapse occurs over time; the effect was treated, but not the cause in its totality. Proper diagnosis, selection and implementation of the most appropriate therapeutic approach require the involvement and collaboration of a multidisciplinary team. The objective of the study was to highlight the advantage of combining manual therapy and myofunctional therapy, along with general relaxation, in patients with a mandible opening limitation in order to regain the harmony of the neuromuscular control and temporomandibular arthrokinematics. Material and methods. 46 patients were divided into 3 groups: group 1 benefited from manual therapy alone, group 2 only myofunctional therapy; group 3, manual therapy together with myofunctional therapy. Results. The data confirm the increased efficacy of the combined therapy used with group 3 compared to the groups where only one type of therapy was applied. Therefore, it is confirmed the importance of involving the multidisciplinary team in addressing the patient with temporomandibular joint dysfunctions. Conclusions. The short- and medium-term outcomes of combined therapy demonstrate the reduction of symptoms without recurrence, an improvement in dental functioning and, as a consequence, an increase in the quality of life of this patient population.

Keywords

• temporomandibular joint
• limited mandible opening
• bruxism
• myofunctional therapy
• pain