@article{Rybert_2018, title={ANALYSIS OF DENTOFACIAL COMPLEX OF PATIENTS WITH COMBINED TEMPOROMANDIBULAR JOINT DISORDERS AND TREATMENT APPROACHES}, volume={2}, url={https://dental-almanac.org/index.php/journal/article/view/142}, abstractNote={<p>The analysis of dentofacial complex of patients with combined disorders of temporomandibular joint that affect muscles (chewing muscles, neck muscles, shoulder muscles) and specifically joints (compression of bilaminar region, displacement of meniscus, hypermobility, arthritis) was conducted.</p> <p>Patients with orthodontic pathology (43.4%), defective eruption of third molars (30.4%) and iatrogenic pathology (26.1%) significantly exceeded among the patients with combined articular disorders.</p> <p>Secondary abnormality of dentition was detected in 17.2% of patients, multiple dental defects – in 13.0%, and periodontitis of I-II degree – in 13.0% as well. The specified abnormalities of dentofacial complex were manifested as both single clinical entities and in various combinations.</p> <p>Rare forms of dental pathology combined with temporomandibular joint disorder were found only in 60.6% of patients. The other 39.4% of patients with combined TMJ disorders presented dentofacial pathologies in various combinations with significant predominance of female patients.</p> <p>Analysis of the myofascial component of combined temporomandibular disorders revealed that chewing muscles were involved in the process of all the patients, the neck muscles – in 69.5% and shoulder muscles – in only one patient (4.3%).</p> <p>Articular component of combined TMJ disorders involved significant predominance in the displacement of meniscus in 78.2% and compression of bilaminar region – in 34.7%. Hypermobility and arthritis were diagnosed in 8.6% of patients respectively.</p> <p>Compression of bilaminar region as a separate entity was diagnosed in 13.0% of the patients, the displacement of meniscus – in 52.2%, and hypermobility – in 4.3%.</p> <p>Articular component of TMJ disorders in the other 30.5% of the patients occurred in conjunction and included such combinations as "compression of bilaminar region + displacement of meniscus", "displacement of meniscus + arthritis", "compression of bilaminar region + displacement of meniscus + hypermobility".</p> <p>In patients with combined TMJ disorders occlusal therapy with occlusal splints of different types of action was performed in 30.5%, occlusal therapy + splintline therapy in 34.8%, occlusal therapy + relevant prosthetics with various kinds of orthopaedic restorations in 21.8%, occlusal therapy + splintline therapy + relevant prosthetics in 8.6%, occlusal therapy with lifetime occlusal splint in 4.3%.</p> <p>Therapeutic decision for such patients is highly individual and it is based on thorough clinical analysis, evaluating additional methods of examination and analysis of functional occlusion in the articulator configured for individual function by patient’s condylography and individual approach to the choice of occlusal splints, if necessary, followed by an orthopedic treatment to restore centric relation and functional occlusion.</p> <p><strong>Keywords</strong>: temporomandibular joint disorders, pathology of dentofacial complex, treatment.</p&gt;}, number={1}, journal={Ukrainian Dental Almanac}, author={Rybert, Yu.O.}, year={2018}, month={Mar.}, pages={68-71} }