Efficacy of combination treatment in a patient with temporomandibular joint dysfunction

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Background: Muscle and joint dysfunction is a common complication, particularly in females over 40 years. It is strongly associated with age-related hormonal changes in the bones, as well as concomitant dentoalveolar deformities and tooth loss.

Case description: The efficacy of combination treatment of dentoalveolar abnormalities and deformities complicated by temporomandibular joint (TMJ) dysfunction was demonstrated. The efficacy of combination treatment in patients with missing teeth, as well as dentoalveolar abnormalities and deformities complicated by TMJ dysfunction, was confirmed. To ensure a representative before-and-after comparison, the restoration of masticatory efficiency following orthodontic and orthopedic rehabilitation was assessed.

A physical examination in patient M. revealed hypertonia of masticatory muscles, restricted mouth opening, jaw shifting to the left, partially absent dentition in distal sections, and prosthetic restoration failure. On MRI, there were signs of deforming arthrosis of both TMJs. The following observation methods were used to assess the efficacy of rehabilitation:

  1. questioning to identify symptoms of TMJ pain; follow-up examination for joint clicking when opening the mouth;
  2. palpation of the external pterygoid muscle, masticatory muscle, and internal pterygoid muscle;
  3. X-ray examination (TMJ CT and MRI) following treatment;
  4. masticatory efficiency assessment using a masticatory performance test (according to Trezubov) before and after treatment.

Diagnostic testing following combination orthodontic and orthopedic treatment revealed that the patient’s left TMJ no longer felt heavy, and she could open her mouth easily; moreover, jaw shifting resolved, and masticatory muscle rigidity decreased.

Conclusion: This clinical case demonstrates why orthopedic surgeons and orthodontists must collaborate in the diagnosis and treatment of TMJ dysfunction. The authors present a well-established approach to the treatment of patients with TMJ dysfunction that has been used successfully in clinical practice for several years.

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作者简介

Olga Guiter

Ryazan State Medical University

Email: gos.stam@mail.ru
ORCID iD: 0000-0003-1707-7015
SPIN 代码: 7745-4210

MD, Cand. Sci. (Medicine), Associate Professor
俄罗斯联邦, Ryazan

Olga Arharova

Ryazan State Medical University

Email: arharovaolga@mail.ru
ORCID iD: 0000-0003-0055-6108
SPIN 代码: 3035-4052

MD, Cand. Sci. (Medicine), Associate Professor
俄罗斯联邦, Ryazan

Valeria Epifanceva

Ryazan State Medical University

编辑信件的主要联系方式.
Email: ya.e1234@yandex.ru
ORCID iD: 0009-0006-7348-2962
俄罗斯联邦, Ryazan

参考

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2. Fig. 1. Left temporomandibular joint (cone beam computed tomography data).

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3. Fig. 2. Right temporomandibular joint (cone beam computed tomography data).

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4. Fig. 3. Installation of the QUADROtech bracket system on the lower jaw in the area of teeth 3.4–4.5.

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5. Fig. 4. Prosthetic replacement of lower jaw teeth with a clasp prosthesis due to missing teeth 3.5, 3.6, 4.6 with support on teeth 3.7, 4.7.

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6. Fig. 5. Masticatory efficiency diagram for patient M. according to Trezubov (before treatment and 1, 3, and 6 months after treatment).

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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