EXPERIENCE IN COMPREHENSIVE DIAGNOSIS AND TREATMENT OF TEMPOROMANDIBULAR DISORDERS IN ADULT PATIENTS WITH ORTHODONTIC PATHOLOGY

Abstract

This article highlights the features of comprehensive diagnostics and treatment of adult patients with orthodontic pathology associated with temporomandibular disorders. Purpose of the study: To present effective diagnostic and therapeutic measures aimed at identifying and restoring static and functional occlusion in patients with temporomandibular disorders on the background of orthodontic pathology with subsequent orthopedic reconstruction. Materials and methods. A comprehensive examination of 44 patients diagnosed with musculoskeletal dysfunctions on the background of orthodontic pathology was conducted, using the manufacture of control jaw models, orthopantomography, zonography, and ultrasonography, computer tomography та magnetic resonance tomography TMJ, functional investigation of TMJ, analysis of occlusal relationships in an individually configured articulator Artex CR (Amamm Girrbach. The diagnosis of temporomandibular disorders was established according to the classification Helkimo. For the diagnosis of orthodontic pathology the Angle classification was used. Splintline therapy, Clear Alginer Protocol were used in the treatment process. Statistical analysis was performed using Excel 2019 for Windows and the Statistica 6.0 program. Results: Based on the obtained data of clinical examination of patients with musculoskeletal dysfunctions on the background of orthodontic pathology, a preliminary diagnosis of TMJ was established according to Helkimo. This group of examined patients underwent comprehensive diagnostics of TMJ with subsequent planning of comprehensive treatment. To normalize muscle-joint relationships, treatment was started with one of the occlusal splint options, and then, when positive results were achieved, they moved on to splint line therapy or the use of hybrid orthodontic splints. Occlusal therapy was applied in 38 (86.4%) patients using, according to indications, different types of splints, and splintline therapy was applied in 27 (61.4%) patients. After completion of orthodontic treatment, patients underwent orthopedic reconstruction. Conclusions: The presence of temporomandibular disorders associated with orthodontic pathology in adult patients requires mandatory thorough examination with the use of modern diagnostic and treatment methods aimed at the simultaneous normalization of both the musculoskeletal complex and the treatment of orthodontic pathology.