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Detection and effectiveness of treatment of myofascial pain and temporomandibular joint pathologies in adult patients with orthodontic pathology
- Authors: Fazylova T.A.1, Ilyin A.A.1, Olesov E.E.2, Radzishevsky B.M.1, Movsesyan V.G.2, Olesova V.N.1
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Affiliations:
- Biomedical University of Innovation and Continuing Education of the Federal Medical Biophysical Center named after A.I. Burnazyan
- Academy of Postgraduate Education
- Issue: Vol 26, No 5 (2022)
- Pages: 397-405
- Section: Clinical Investigation
- URL: https://rjdentistry.com/1728-2802/article/view/107535
- DOI: https://doi.org/10.17816/dent107535
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Abstract
BACKGROUND: At the orthodontist’s clinic, patients with pain in the maxillofacial region and internal disorders of the temporomandibular joint (TMJ) are not uncommon. These pathological conditions are characterized by the complexity of interdisciplinary therapy and frequent recurrence.
AIM: To analyze the detectability and effectiveness of treatment of myofascial pain disorders and internal disorders of the TMJ in adult patients with dental anomalies.
MATERIAL AND METHODS: Case histories of 300 adult patients with dental anomalies who underwent examination and treatment in a multidisciplinary dental clinic were retrospectively analyzed. The study included patients who received orthodontic treatment for at least 5 years. The prevalence and structure of internal disorders of the TMJ and myofascial pain disorders were assessed, and their correlation was analyzed.
RESULTS: Orthodontic treatment was more often needed by patients with myofascial pain (71.5%), followed by those with myofascial facial pain syndrome (28.3%). In these patients, internal TMJ disorders and maxillary anomalies of class II according to Engl with unilateral distal occlusion, deep bite, and class I with crowding of teeth were more often detected. Internal TMJ disorders with concomitant myofascial pain disorders in the form of myofascial pain were observed in 82.4% of the patients. Myofascial pain disorders without internal TMJ disorders were registered in 17.4% of the patients. The overall effectiveness of the treatment of internal TMJ disorders and myofascial pain disorders was 46.4%, no lasting improvement was observed in 35.7%, deterioration was recorded in 17.8%, and relapses were noted in 60.7%. In the treatment of myofascial pain disorders without internal TMJ disorders, the overall effectiveness of treatment was 5.5%; stabilization, 50.0%; and deterioration, 44.4%.
CONCLUSION: Myofascial facial pain is very difficult to treat. The combination with internal TMJ disorders creates significant and sometimes insurmountable difficulties in the orthodontic treatment of adults. All these forces specialists to look for new approaches to optimizing orthodontic treatment of TMJ pathology and myofascial pain disorders.
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About the authors
Tatiana A. Fazylova
Biomedical University of Innovation and Continuing Education of the Federal Medical Biophysical Center named after A.I. Burnazyan
Email: tfazylova@yandex.ru
ORCID iD: 0000-0001-5878-6761
SPIN-code: 5248-5572
MD, Assistant
Russian Federation, MoscowAlexander A. Ilyin
Biomedical University of Innovation and Continuing Education of the Federal Medical Biophysical Center named after A.I. Burnazyan
Author for correspondence.
Email: Alex2017ilyin@yandex.ru
ORCID iD: 0000-0002-8021-4599
SPIN-code: 2615-2137
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowEgor E. Olesov
Academy of Postgraduate Education
Email: olesov_georgiy@mail.ru
ORCID iD: 0000-0001-9165-2554
SPIN-code: 8924-3520
MD, Dr. Sci. (Med.), Associate Professor
Russian Federation, MoscowBoris M. Radzishevsky
Biomedical University of Innovation and Continuing Education of the Federal Medical Biophysical Center named after A.I. Burnazyan
Email: 3make@mail.ru
MD, Assistant
Russian Federation, MoscowVagarshak G. Movsesyan
Academy of Postgraduate Education
Email: vanya.movsesyan@gmail.com
ORCID iD: 0000-0001-6218-5387
Postgraduate Student
Russian Federation, MoscowValentina N. Olesova
Biomedical University of Innovation and Continuing Education of the Federal Medical Biophysical Center named after A.I. Burnazyan
Email: olesova@implantat.ru
ORCID iD: 0000-0002-3461-9317
SPIN-code: 6851-5618
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowReferences
- Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St. Louis: Elsevier; 2013. 504 p.
- Khvatova VA. Clinical gnathology. Moscow: Meditsina; 2011. 296 p. (In Russ).
- Schiffman E, Ohrbach R, Truelove E, et al.; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014;28(1):6–27. doi: 10.11607/jop.1151
- Sysolyatin PG, Ilyin AA, Dergilev AP. Classification of diseases and injuries of the temporomandibular joint. Moscow: Meditsinskaya kniga; Nizhny Novgorod: Izdatel’stvo NGMA; 2001. 79 p. (In Russ).
- Dawson PE. Functional occlusion: from the temporomandibular joint to smile planning. Moscow: Prakticheskaya meditsina; 2016. 592 p. (In Russ).
- Kandasami S, Green CS, Rinchuz DD, Stockstill DW. Temporomandibular joint dysfunction in orthodontics: a clinical guide. Moscow: TARKOMM; 2021. 144 p. (In Russ).
- Yang Ch, He D, Chen M, et al. Combined Joint-Jaw-Occlusion therapy: a new theory and our protocol. Almanac of Clinical Medicine. 2017;45(6):440–459. (In Russ). doi: 10.18786/2072-0505-201745-6-440-459
- Kudryavtseva OA. Features of diagnosis and treatment of patients with dentoalveolar anomalies complicated by diseases of the temporomandibular joints. Kazan: Buk; 2019. 80 p. (In Russ).
- Brega IN, Zheleznyy PA, Adonyeva AV, et al. Clinical and functional substantiation for complex treatment staging in patients with the temporomandibular joint disk displacement with reduction of bite pathology and the hypertonicity of the masticatory muscles. Siberian Scientific Medical Journal. 2018;38(4):105–113. (In Russ). doi: 10.15372/SSMJ20180414
- Dym H, Bowler D, Zeidan J. Pharmacologic Treatment for Temporomandibular Disorders. Dent Clin North Am. 2016;60(2):367–379. doi: 10.1016/j.cden.2015.11.012
- Dimitroulis G. Management of temporomandibular joint disorders: A surgeon’ s perspective. Aust Dent J. 2018;63(Suppl. 1):S79–S90. doi: 10.1111/adj.12593
- Semkin VA, Volkov SI. Diseases of the temporomandibular joint. Moscow: GOETAR-Media; 2016. 288 p. (In Russ).
- Bekreyv VV. Diagnostika i kompleksnoye lecheniye zabolevaniy visochno-nizhnechelyustnogo sustava [dissertation]. Moscow; 2019. 333 p. (In Russ).
- Orlova OR, Alekseeva AYu, Mingazova LR, Konovalova ZN. Bruxism as a neurological problem (literature review). Neuromuscular Diseases. 2018;8(1):20–27. (In Russ). doi: 10.17650/2222-8721-2018-8-1-20-27
- Yang C, Hu Y. Evaluation of arthroscopic disc repositioning: a prospective study. Almanac of Clinical Medicine. 2017;45(6):471–477. (In Russ). doi: 10.18786/2072-0505-2017-45-6-471-477
- Guo YN, Cui SJ, Zhou YH, Wang XD. An Overview of Anterior Repositioning Splint Therapy for Disc Displacement-related Temporomandibular Disorders. Curr Med Sci. 2021;41(3):626–634. doi: 10.1007/s11596-021-2381-7
- International classification of orofacial pain, 1st edition (ICOP). Adapted Russian version. Almanac of Clinical Medicine. 2022;50(S):1–82. (In Russ). doi: 10.18786/2072-0505-2022-50-005
- Fadeev RA, Ovsyannikov KA, Zhidkikh ED. The use of occlusive mouthguards and medical diagnostic devices for the treatment of diseases of the temporomandibular joint and masticatory muscles. Institute of Dentistry. 2020;(3):78–80. (In Russ).
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