THE DYNAMICS STUDY OF PATIENTS STATE WITH MUSCLE AND JOINT DYSFUNCTION OF TMJ, WHICH DECIDED TO COMPLETE THE TREATMENT AFTER ELIMINATION OF THEIR DISEASE SYMPTOMS ACHIEVED BY USING THE OCCLUSION EQUIPMENT

Abstract

Abstract. The article is concerned with the most relevant and insufficiently studied problems of modern orthopedic dentistry.

Objective. To study the dynamics of patients state with muscle and joint dysfunction of TMJ, which decided to complete the treatment after elimination of their disease symptoms achieved by using the occlusion equipment and not go through the finish the treatment.

Materials and Methods. 25 patients were involved in the study: 8 (32.0%) men and 17 (68.0%) women aged from 35 to 60 years (average age 46.16 ± 1.47 years), which among 360 patients were diagnosed a muscle and joint dysfunction of TMJ and successfully underwent treatment in 2015-2019 in a multi-field dental clinic (Kharkiv, Ukraine). Methods of general clinical examination of the state of the dento maxillofacial complex were used.

These patients underwent examination before treatment, then after eliminating the symptoms of the disease and restoring the normal masticatory process using occlusal splints, and then 1 month after stopping wearing the splint, and 1 and 1.5 years after the end of treatment.

Conclusions. The examination confirmed the diagnosis in all 25 patients: "muscle and joint dysfunction of TMJ of occlusal origin." All 25 (100%) patients had occlusion disorders due to an edentulous space in the lateral parts of the lower and / or upper jaw.

An individual treatment plan was developed for each patient in accordance with the algorithm considered in the article using the author's modified method of percutaneous electroneurostimulation and the proposed occlusal splint structure.

Because of the treatment carried out during 3.5 ± 0.7 months, all 25 patients haven’t had any clinical aspects of muscle and joint dysfunction of the TMJ and all of them have had normal physiological functioning of the masticatory muscles and TMJ, which was confirmed by objective examination methods, including special ones.

These 25 patients refused to complete the final stage of treatment (the manufacture of temporary and permanent prostheses), but agreed to remain at the regular or periodical medical check-up.

In two weeks after the stop of wearing the equipment, 17 of 25 patients (68.0%) gradually began to fill certain symptoms of dysfunction: severity and discomfort in the TMJ, tightness and tenderness of the masticatory muscles.

4 weeks after examination determined that 24 out of 25 patients (96.0%) had a disease recurrence, their condition almost returned to the primary state, and was confirmed by objective methods of examination. However, after 4 weeks of wearing the newly manufactured medical occlusal splint, all the symptoms of dysfunction in all patients disappeared, the electromyograms and arthrophonorgamm values returned to normal. The patients underwent the final stage of treatment - temporary and then permanent prostheses were made.

Examinations conducted in one and one and a half years after the fixation of permanent prostheses showed that disease recurrence was not observed, there were no complaints from patients.

Conclusions. In patients with muscle and joint dysfunction of TMJ of occlusal origin, it is unacceptable to stop treatment at the stage of eliminating only the clinical symptoms of the disease, since in 96% of cases it leads to a disease recurrence within the first month after the termination of wearing the occlusal splint. A prerequisite for ensuring long-term stable results of treatment of TMJ dysfunction of occlusal origin in patients with edentulous spaces is a full treatment cycle, an integral component of which is rational prosthetics, which is confirmed by control examinations carried out in 1 and 1.5 years after the end of treatment.