Determination of the spatial movement of the temporomandibular joints (tmj) joint heads in patients with muscle and joint dysfunction according to computed tomography (ct)
Keywords:Muscle and joint dysfunction of temporomandibular joints, computed tomography
Computed tomography (CT) is the one of most objective diagnostic methods of TMJ MJD it allows define amplitudes of joint heads movement in sagittal projections to detect an asymmetry of TMJ elements location.
Aim of research. Assessment of location of mandibular joint heads and determination of its spatial position in patients with TMJ MJD before treatment and after it using CT.
Materials and methods. 50 patients 28-62 years old, 37 women and 13 men who underwent computed tomography (CT) of TMJ were under observation.The results of observation were analyzed in details.
The studies were carried out using cone-radial computed tomographic scanner «Vatech Pax uni 3d». CT of TMJ was carried out in habitual occlusion before the start of treatment and after removal of TMJ MJD symptoms and complaints. At the study there were measured the width of joint fissure in front, upper and back segments according to N.A. Rabuhina methodology in N.E. Androsova and so-authors modification. Statistical analysis of the data received was carried out using «Statistics» (Statsoft, Inc) program.
Results. The results of TMJ CT in patients before the start of treatment demonstrated that the sizes of TMJ joint fissure were different. The width of the upper segment of TMJ joint fissure in patients before the start of treatment was reliably less (≤0,001) comparing with an analogous parameter in the group of patients after treatment that indicates the upper location of mandibular head in TMJ with reducing the height of the lower segment of face.
So the data of study of the joint fissure width received using TMJ CT demonstrate formation of specific outlines of joint fissure at displacement of mandible and consequently joint head. Information about the joint fissure parameters allows rationally plan and realize orthopedic treatment and the necessary rehabilitation measures in patients with TMJ MJD.
Conclusions. The studies demonstrated that the displacements of mandibular joint heads relative to articular tubercle (at p≤0,005) were detected in all patients with MJD. After treatment and removal of the symptoms of disease the parameters of mandibular heads in socket approached to the normal ones (at p≤0,005). The use of CT for spatial determination of mandibular joint heads can be considered as an additional objective method of diagnostics for successful treatment of patients with TMJ MJD
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