Можливості неінвазивного лікування обмеженого відкривання рота, обумовленого захворюваннями та внутрішніми порушеннями скронево-нижньощелепного суглоба

Abstract

Abstract. Magnetic resonance imaging is widely used in the presence of such patient complaints as clicking, locking and pain in the temporomandibular joint. The different problems in the treatment of temporomandibular joint pathology, which is accompanied by limited mouth opening, requires certain recommendations for magnetic resonance imaging, supported by current classifications. The purpose of the study: to substantiate the need for the use of an individual mandibular fixator, made before magnetic resonance imaging in the open mouth position to systematization of the treatment outcomes. Materials and methods. On the basis of clinical examination and objectification of the temporomandibular joint status by magnetic resonance imaging the results of treatment of diseases and internal disorders of the temporomandibular joint, which can be obtained by a dentist-gnathologist using non-invasive methods, was analyzed. To obtain images after treatment of the temporomandibular joint an individual mandibular fixator was used, which provided the possibility of evidencebased determination of the articular head position in the open mouth state. To systematize the analysis results of magnetic resonance imaging of the temporomandibular joint, the most convenient classification was chosen. Results. From a clinical sight, the gnathological treatment of temporomandibular joint dislocation without reposition is considered effective if the distance between the incisors, at maximum mouth opening, is 41–50 mm, the articular head is located at the apex of articular tubercle, and in the questioning and isometric tests the patient complaints are absent. Conclusions. The most effective non-invasive treatment of limited mouth opening is possibly with early ambulation, i.e. from three to seven months after onset. Key words: temporomandibular joint, gnathologist, magnetic resonance imaging.