Медична наука України (Feb 2020)
ANALYSIS OF EFFICIENCY OF THE TEMPORO-MANDIBULAR DISORDERS TREATMENT
Abstract
Relevance. Treatment of the temporo-mandibular joint (TMJ) dysfunctions still stays an urgent issue of modern stomatology. Its significance is predisposed for its high incidence and annual increase in patients’ referrals as well as diversity of it clinical manifestations, complexity of diagnosis and treatment, variability of clinical pattern, which requires a multi-disciplinary approach. According to Ukrainian and foreign authors, the TMJ pathologies take up the third place after caries and parodontal diseases, being diagnosed in 20 % of children and almost 87 % of adults. The share of patients with the TMJ dysfunction increases every year. The 79 % are represented with the intra-capsular disorders of the temporo-mandibular joints. The study was necessitated by the fact that there is still no single agreement in the treatment methods and definite treatment protocols regarding the intracapsular TMJ disorders. Objectives: analysis of efficiency of the TMJ intracapsular disorders patients’ treatment using the pathogenetically rationalized conservative and mini-invasive surgical methods. Methods and materials. The study includes the data of 38 patients with complaints of the TMJ region pain and the TMJ dysfunction. All patients were examined according to the common protocol. According to the disorder stage, the patients were administered either the conservative treatment course using the treatment tray on the mandible or maxilla, with the subsequent orthopedic or prosthetic treatment, or the splint therapy with subsequent surgical intervention. Results. Having analyzed the dynamical pattern of the treatment outcomes within the study, it has been detected that the surgical injection correction of the TMJ disorders was effective in all examined patients. To provide for the long-term steady treatment outcome the prosthetic-orthopedic rehabilitation measures were indicated, aimed at preserving the correct occlusion relation. Conclusion. The method of hyaluronic acid preparations injection into the TMJ cavity as a stage of the TMJ dysfunction therapy has proven its effectiveness in all the examined patients. In order to achieve the long-term steady result, the patients were recommended prosthetic-orthopedic rehabilitation for producing and supporting the occlusion relation.
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