Dentist № 4 (43) – 2021, pp. 47-55 SCIENTIFIC PUBLICATION
Algorithm of the morphofunctional diagnostics of the dentoalveolar system of patients with malocclusions associated with the temporomandibular joints diseases
S.V. Tekuchevaa, L.S. Persinb, Yu.I. Afanasyevac, M.A. Postnikovd, I.V.Popovaa, E.M. Postnikovae
aMD, PhD, Associate Professor, Moscow state university of medcine and dentistry, Moscow, Russia
bMD, PhD, DMSci, Professor, Corresponding Member of RAS, Moscow state university of medcine and dentistry, Moscow, Russia
cMoscow state university of medcine and dentistry, Moscow, Russia
dMD, PhD, DMSci, Associate Professor, Samara state medical University, Samara, Russia
eI.M. Sechenov First Moscow State Medical University, Moscow, Russia
https://doi.org/10.32993/dentist.2021.4(43).12
ABSTRACT
The aim of the study. To develop and demonstrate an algorithm for morphofunctional diagnostics of the dentoalveolar system of a patient with a skeletal form of Class III malocclusion (mesial occlusion) in combination with internal disorders of the temporomandibular joints (TMD) on a clinical example.
Objects and methods. A clinical example of examination of a patient with a skeletal form of mesial occlusion (gnathic form of mesial occlusion) associated with TMD, using the developed algorithm, which included clinical, anthropometric, Х-rays, functional, ultrasound methods and MRI is presented.
Results and discussion. The algorithm for complex diagnostics of the dentoalveolar system is described and tested on the patient with a (gnathic form of mesial occlusion) skeletal form of mesial occlusion, complicated by internal disorders of the TMJ; as a result of it’s use the differential diagnosis and the treatment plan were made, including splint therapy, followed by combined orthodontic-surgical treatment.
Conclusion. We have developed a comprehensive approach for the diagnostics of the stomatognathic system of patients with malocclusions associated with internal derangements of TMJ using modern methods, which allows to systematize the data obtained during the examination for making a differential diagnosis, treatment plan, objectively assessing the dynamics of indicators during and after treatment.
Keywords: diseases of the temporomandibular joints, internal derangements of the temporomandibular joints, temporomandibular disorder, malocclusions, morphofunctional diagnostics, mesial occlusion
References
- Arsenina O.I., Popova A.V., Gus L.A. Znachenie okkljuzionnyh narushenij pri disfunkcii visochno-nizhnecheljustnogo sustava [The value of occlusive disorders in temporomandibular joint dysfunction]. Stomatologija. – Dentistry. 2014, vol. 93, no. 6, pp. 64–67, doi: https://doi.org/10.17116/stomat201493664-67
- Iordanishvili A.K., Serikov A.A., Soldatova L.N. Funkcional’naja patologija zhevatel’no-rechevogo apparata u molodyh [Functional pathology of the masticatory-speech apparatus in young people]. Kubanskij nauchnyj medicinskij vestnik. – Kuban Scientific Medical Bulletin. 2016, no. 6 (161), pp. 72–76. doi: https://doi.org/10.25207/1608-6228-2016-6
- Lepilin A.V., Konnov V.V., Bagarjan Je.A., Arushanjan A.R. Klinicheskie projavlenija patologii visochno-nizhnecheljustnyh sustavov i zhevatel’nyh myshc u pacientov s narushenijami okkljuzii zubov i zubnyh rjadov [Clinical manifestations of pathology of temporomandibular joints and masticatory muscles in patients with impaired occlusion of teeth and dentition]. Saratovskij nauchno-medicinskij zhurnal (jelektronnyj resurs). – Saratov Journal of Medical Scientific Research (electronic jornal). 2010, vol. 6, no. 2, pp. 405–410. Available at: https://cyberleninka.ru/article/n/klinicheskie-proyavleniyapatologii-visochno-nizhnechelyustnyh-sustavov-i-zhevatelnyh-myshts-u-patsientov-s-narusheniyami-okklyuzii
- Konnov V.V., Pichugina E.N., Popko E.S., Arushanjan A.R., Pylaev E.V. Myshechno-sustavnaja disfunkcija i ee svjaz’ s okkljuzionnymi narushenijami [Muscular-articular dysfunction and its connection with occlusive disorders]. Sovremennye problemy nauki i obrazovanija (jelektronnyj resurs). – Modern problems of science and education (electronic jornal). 2015, no. 6-S, pp.131–138. Available at: https://science-education.ru/ru/article/view?id=23298
- Fadeev R.A., Ovsjannikov K.A. Jetiologija i patogenez zabolevanij visochno-nizhnecheljustnogo sustava i zhevatel’nyh myshc [Etiology and pathogenesis of diseases of the temporomandibular joint and chewing muscles]. Vestnik Novgorodskogo gosudarstvennogo universiteta. – Bulletin of the Novgorod State University. 2020, no. 4 (120), pp. 50–59, doi: https://doi.org/10.34680/2076-8052.2020.4(120).50-59
- Chhikvadze T.V., Bekreev V.V. Okkljuzionnaja terapija narushenij funkcij visochno-nizhnecheljustnogo sustava [Occlusive therapy of temporomandibular joint dysfunctions]. Medicinskij zhurnal RUDN. – Medical journal of RUDN. 2018, no. 22 (4), pp. 387–401, doi: https://doi.org/10.22363/2313-0245-2018-22-4-387-401
- Chao Zhang, Jun-Yi Wu, Dong-Lai Deng, Bing-Yang He, Yuan Tao, Yu-Ming NiuMo-Hong Deng. Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis. Oncotarget, 2016, vol. 7, no. 51, pp. 84043-84053, doi: https://doi.org/10.18632/oncotarget.13059
- Gye Hyeong Lee,Jae Hyun Park, Da Nal Moon, Sang Mi Lee. Protocols for orthodontic treatment of patients with temporomandibular joint disorders. American Journal of Orthodontics and Dentofacial Orthopedics, 2021, vol. 159, no. 3, pp. 373–388, doi: https://doi.org/10.1016/j.ajodo.2020.09.023
- Postnikov M.A., Trunin D.A., Nesterov A.M., Gabdrafikov R.R, Sadykov M.I., Potapov V.P., Pankratova N.V. Use of occlusal digital splint for treating the patients with temporomandibular joint dysfunction and planning orthopedic treatment (electronic jornal). Russian Open Medical Journal, 2020, vol. 9 (2), pp. 7–14. Available at: https://romj.org/2020-02
- Najdanova I.S., Pisarevskij Ju.L., Shapovalov A.G., Pisarevskij I.Ju. Vozmozhnosti sovremennyh tehnologij v diagnostike funkcional’nyh narushenij visochno-nizhnecheljustnogo sustava (obzor literatury) [Possibilities of modern technologies in the diagnosis of functional disorders of the temporomandibular joint (literature review)]. Aktual’nye problemy stomatologii. – Actual problems of dentistry. 2018, vol. 14, no. 4, pp. 6–13, doi: https://doi.org/ 10.18481/2077-7566-2018-14-4-6-13
- Postnikov M.A., Slesarev O.V., Andrijanov D.A. Rentgenoanatomija visochno-nizhnecheljustnogo sustava u pacientov s zuboal’veoljarnoj i gnaticheskoj formami mezial’noj okkljuzii na jetape planirovanija ortodonticheskogo lechenija [X-ray anatomy of the temporomandibular joint in patients with dentoalveolar and gnathic forms of mesial occlusion at the planning stage of orthodontic treatment]. Sovremennye problemy nauki i obrazovanija (jelektronnyj resurs). – Modern problems of science and education (electronic jornal). 2017, no. 6. Available at: https://science-education.ru/article/view?id=27275
- Postnikov M.A., Slesarev O.V., Andrijanov D.A., Osadchaja E.I. Konusno-luchevaja komp’juternaja tomografija i ul’trazvukovaja vizualizacija v kompleksnoj ocenke anatomo-funkcional’nogo sostojanija visochno-nizhnecheljustnogo sustava [Cone-beam computed tomography and ultrasound imaging in a comprehensive assessment of the anatomical and functional state of the temporomandibular joint]. Sovremennye problemy nauki i obrazovanija (jelektronnyj resurs). – Modern problems of science and education (electronic jornal). 2019, no. 5. Available at: https://www.scienceeducation.ru/article/view?id=27848
- Postnikov M.A., Slesarev O.V., Trunin D.A., Andrijanov D.A., Ispanova S.N. Avtomatizirovannyj analiz rentgenovskih izobrazhenij visochnonizhnecheljustnogo
sustava u pacientov s ortognaticheskim prikusom i fiziologicheskoj okkljuziej [Automated analysis of X-ray images of the temporomandibular joint in patients with orthognathic occlusion and physiological occlusion]. Vestnik rentgenologii i radiologii. – Bulletin of roentgenology and radiology. 2019, vol. 100, no. 1, pp. 6–14, doi: https://doi.org/10.20862/0042-4676-2019-100-1-6-14 - Tekucheva S.V., Ermol’ev S.N., Zajler A.S., Persin L.S., Janushevich O.O., Postnikov M.A. Ul’trazvukovaja ocenka zhevatel’nyh myshc pri razlichnyh tipah rosta licevogo cherepa [Ultrasound assessment of masticatory muscles in different types of facial skull growth]. Stomatologija. – Dentistry. 2021, vol. 100, no. 3, pp. 72–81, doi: https://doi.org/10.17116/stomat202110003172
- Tekucheva S.V., Ermol’ev S.N., Gulanjan G.A. Ocenka rezul’tatov makroskopicheskogo i ul’trazvukovogo issledovanija zhevatel’nyh myshc [Assessment of the results of macroscopic and ultrasound examination of the chewing muscles]. Ortodontija. – Orthodontics. 2021, no. 3 (95), pp. 79–80.
- Tekucheva S.V., Oborotistov N.Ju., Porohin A.Ju. Cifrovye tehnologii v ortodontii: programmnyj kompleks ORTHO3D [Digital technologies in orthodontics: ORTHO3D software]. Ortodontija. – Orthodontics. 2018, no. 2 (82), pp. 12–26.
Correspondence to: Е-mail: tekuchevasv@yandex.ru