Assessment of structural body imbalances in patients with temporomandibular joint dysfunction

Abstract

Introduction. Temporomandibular joint (TMJ) dysfunction is the second most common musculoskeletal disease, affecting up to 33 % of people during their lifetime. The multicomponent etiopathogenesis of the disease actualizes the use of diagnostic criteria for the early symptoms of developing functional disorders. The algorithm for preclinical examination of the TMJ must be used already in the dentist′s office, which will allow to avoid the unpredictable results of dental rehabilitation and in time to attract other specialists to the complex therapy of the patient. The etiopathogenesis of TMJ dysfunction indicates the need for a closer study of the mutual infl uence of structural imbalances in the body and dentition, the determination of the primary disorder, which will help to develop a system for the prevention of TMJ dysfunctions, and may also affect the sequence, volume and nature of the treatment for this pathology.The goal of research — to identify the relationship of structural imbalances in the body and temporomandibular joint dysfunction.Materials and methods. From September to December 2019, a prospective study of 70 volunteers among university students was conducted at the Department of Orthopedic Dentistry of Omsk State Medical University. During the processing of clinical material, 6 people retired in accordance with exclusion criteria. All subjects underwent an assessment of the state of the dentofacial system, primarily the TMJ (using a short Hamburg test) and structural imbalances of the body (using the Notch Interfaces Inc. motion capture and reconstruction system). To assess the cervical-cranial relationship in the subjects who had 3–6 points according to the results of the Hamburg test, a head X-ray was make in lateral projection, and cephalometric analyzes were performed according to Rocabado and Sassuni. The presence and strength of the linear relationship between the phenomena was determined using the Pearson coefficient.Results. According to the results of the Hamburg test, a functional norm was revealed in only 12,5 % of the examined; TMJ dysfunction was revealed in the vast majority of volunteers (57,9 %). Structural imbalances of the body were detected in 82,8 % of cases. Patients with established by the results of the Hamburg test TMJ dysfunction were underwent cephalometric analysis. Structural changes in the TMJ were not found in the subjects according to the X-ray studies results. There was a high positive relationship between functional TMJ dysfunction and pelvic hyperfl exion (ρ=0,72, p<0,05), and an average positive relationship (ρ=0,55, p<0,05) between the head and neck forward tilting. A positive weak relationship was observed between the risk of TMJ dysfunction developing (2 points according to the Hamburg test) and pelvic hyperfl exion (ρ=0,31, p<0,05).Conclusion. The study showed a strong positive relationship between pelvic hyperfl exion and TMJ dysfunction signs; an average positive relationship between TMJ functional impairment and head and neck forward tilting. It was also found that in individuals with TMJ dysfunction signs there were no radiological signs of structural changes in the joint, which indicates the potential reversibility of the revealed disorders and the need for their timely detection and correction. This study is pilot and will be continued in a broader format.