Detection and effectiveness of treatment of myofascial pain and temporomandibular joint pathologies in adult patients with orthodontic pathology

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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, Moscow

Alexander 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, Moscow

Egor 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, Moscow

Boris 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, Moscow

Vagarshak G. Movsesyan

Academy of Postgraduate Education

Email: vanya.movsesyan@gmail.com
ORCID iD: 0000-0001-6218-5387

Postgraduate Student

Russian Federation, Moscow

Valentina 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, Moscow

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