SYMMETRY OF DYNAMIC CHANGES OF ARTICULAR DISC AT PRESENCE OF INTERNAL DISORDERS OF THE TMJ ACCORDING TO MRI DATA.
The aim of our study was to determine and unify structural damages and topographical changes in case of articular disc displacement according to results of MRI diagnostics. The study was completed with apparatus «Siemens Magneton Avanto 1,5Т» (Germany) in TMJ Osag FSE T2 (oblique sagittal cut) positioning with closed and opened mouth.
Central position of the disk on the right side with a closed mouth was found in 8 (38%) cases; with opened mouth – 17 (81%) cases; on the left side with a closed mouth was found in 12 (57%) cases; in an opened mouth - in 15 (71%) cases. Frontal position of the disk on the right side with a closed mouth was diagnosed in 13 (62%) cases; with an opened mouth –14 (19%) cases; on the left side with a closed mouth was found in 9 (43%) cases; with an opened mouth in 6 (29%) cases. Complete frontal disk position on the right side with a closed mouth was diagnosed in 10 (48%) cases; with an opened mouth on the right side and a closed mouth on the left side in 1 (5%) cases. On the left side with an opened mouth, complete frontal position of the discs was not found. The frontal 2/3 drive position on the right side with a closed mouth was diagnosed in 2 (10%) cases; with opened mouth – 3 (14%) cases; on the left side with a closed mouth occurs in 7 (33%) cases; with an opened mouth in 5 (24%) cases. The frontal 1/2 disk position on the right side with a closed mouth was diagnosed in 1 (5%) cases; with an open mouth – was not diagnosed; on the left side with a closed mouth was not found; with an opened mouth in 1 (5%) case.
Anatomical changes of discs placement on the right side TMJ was not present in 13 (62%) cases; on the left side, there is a change in 17 (81%) cases. Disk was thinned in 5 (24%) on the right side; on the left side it was not thinned. Different changes of discs occurred in 3 (14%) cases on the right side; on the left side in 4 (19%) cases.
The central position of the disks on the right and left sides with closed mouth occurred in 1 (35%) case; with opened mouth on the right side in 28 (96.5%) cases; on the left side with opened mouth in 27 (93%) cases. The frontal 2/3 disk position with closed mouth on the right side was diagnosed in 16 (55%) cases; on the left side was found in 20 (69%) cases. The frontal 1/2 disk position on left with the right side with a closed mouth – 1 (35%) case; with an opened mouth on both sides was not diagnosed. The frontal 1/3 disk position was not observed.
Anatomical changes of the discs on the right side of the TMJ were present in 23 (79%) cases, on the left side there were changes in 24 (83%) cases. Thinning of the disks on the right and left sides was not observed. Degenerative changes in disks occurred in 6 (21%) cases on the right side; on the left side - 5 (17%) cases. Results of the examination of position and form of articular disks in the control group, which included 25 patients: disk position was central with closed mouth and did not change with opened mouth in 100% of cases. A form of articular disk did not change also.
An investigation of topographic–anatomical changes in particular disks allows planning of prosthetic treatment within the complex treatment of TMJ pathology.
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