The role of functional therapy in temporomandibular joint pain dysfunction: pathophysiological and clinical aspects

Nowadays, each second patient seeking dental care suffers from some pathology of the temporomandibular joint. Most often patients are diagnosed with temporomandibular joint pain dysfunction syndrome, which is poorly treatable and often relapses. Objective: to evaluate changes in the clinical course of TMJ pain dysfunction syndrome when using myogymnastics in the complex rehabilitation of patients suffering from this pathology. Materials and methods. We performed dynamic observation of 62 young patients who suffered from painful dysfunction of the temporomandibular joint, revealed during the preparation of patients for dental prosthetics. Group 1 included 31 people who were treated with the conventional complex treatment to relieve painful dysfunction. Group 2 included 31 people, for the treatment of which the same standard complex of therapeutic and prophylactic measures with the additional application of masticatory muscles myogymnastics was applied. To objectivize the efficiency of using myogymnastics we used the method of severity degree evaluation as well as semi-quantitative method of efficiency evaluation of the treatment of the pathology in question. Results. It was found out that application of masticatory muscles myogymnastics in the complex treatment of painful dysfunction of the temporomandibular joint allows increasing the efficiency of dental rehabilitation of such patients by 6,9% and decreasing the number of patients with recurrence of the disease by 16,1% in the period up to 2 years. Conclusion. As a pathogenetic functional method of treatment of painful temporomandibular joint dysfunction, application of masticatory muscle myogymnastics to patients allowed to develop mutually consistent reflexes of the masticatory muscles, causing movements of the mouth opening (lowering the lower jaw) without its deviation and advancement. It is advisable to include the technique of masticatory muscle myogymnastics for painful TMJ dysfunction in the clinical guidelines.

1. Iordanishvili A.K. Clinical orthopedic dentistry. Moscow: Medpress-Inform, 2007. 248 p. (in Russ.)

2. Farman A.G., Scarfe W.C. The basics of maxillofacial cone beam computed tomography. Seminars in Orthodontics. 2009;15(1):2.

3. Helkimo M. Epidemiological surveys of dysfunction of the masticatory system. In: Temporomandibular Joint and Dysfunction. Copenhagen: Munksgaard, 1979: 175-192.

4. Iordanishvili A.K. Fundamentals of dental arthrology. Saint-Petersburg: Chelovek, 2018. 176 p. (in Russ.)

5. Kurlyandsky V.Y., Khvatova V.A., Volozhin A.I., Lavochnik M.I. Research methods in orthopedic stomatology. Tashkent: "Medicina" Publisher of the Uzbek SSR, 1973. 232 p. (in Russ.)

6. Helkimo M. Studies on function and dysfunction of the masticatory system. II. Index for anamnestic and clinical dysfunction and occlusal state. Swed Dent J. 1977;67:101-121.

7. Nithipatikom K., Endsley M.P., Moore J.M., Isbell M.A., Falck J.R., Campbell W.B., Gross GJ. Effects of selective inhibition of cytochrome P-450 omega-hydroxylases and ischemic preconditioning in myocardial protection. Am J Physiol Heart Circ Physiol. 2006;290(2):H500-505. DOI: 10.1152/ajpheart.00918.2005.

8. Iordanishvili A.K. Physiology and pathophysiology of the masticatory apparatus. Saint-Petersburg: Chelovek, 2016. 68 p. (in Russ.)

9. Iordanishvili A.K. Geriatric Dentistry. Saint-Petersburg: Chelovek, 2019. 348 p. (in Russ.)

10. Rubinov I.S. Physiological bases of stomatology. Leningrad: Meditsyna, 1970. 334 p. (in Russ.)