Abstract
This article examines the imaging anatomy of the temporomandibular joint (TMJ), describes the technique of calculating the gaps between the fossa and the head, their comparison based on TMJ computed tomography (CT) data, and their comparison with clinical signs of TMJ dysfunction. The aim was to determine CT diagnostic criteria for persistent functional displacement of the lower jaw in patients with TMJ functional disorders in occlusal-articulation disorders at the stage of orthopedic treatment planning. Research materials and methods. A clinical and radiological examination of 150 patients with functional disorders of the masticatory apparatus and occlusal disorders, who were included in the experimental group, and 30 practically healthy persons – the control group, was carried out. The results. The presence of a pain syndrome was primarily determined - 60 patients (40.00%) complained of pain in the TMJ area, masticatory muscles or headache, and in 19 (31.67%) of them, complaints of pain bothered more than half year TMJ pain was found in 30 (20.00%) patients, in masticatory muscles in 43 (28.67%), headache in 47 (31.33%). Hypertonus of the masticatory muscles was established - 94 - 62.67% with their hypertrophy - 46 - 30.67%, both unilateral and bilateral, which were observed simultaneously with the parafunction of the masticatory muscles (34 - 22.67%). Palpatory functional stable displacement of the lower jaw was determined in 135 (90.00%) patients of the research group, in 57 (42.22%) of them significant pain syndrome was present in 46 (80.70%). At the same time, deviation or deflexion was established in 74 (49.33%) patients of the experimental group, restriction of mouth opening in 52 (32.67%) patients; crunching and clicking in the TMJ - 112- 74.67%. The presence of bilateral posterior displacement of the heads of the lower jaw was established in 103 (68.67%) patients with TMJ dysfunction, of which 42 (40.77%) came to the doctor with complaints of orofacial pain, and in 22 (14.67%) significant displacement, 17 (77.27%) of them had a pain syndrome; unilateral posterior displacement of the heads of the lower jaw in 32 (21.33%) patients with TMJ dysfunction, 16 (50.00%) of them have a pain syndrome, and 11 of them have a significant displacement; in 16 (10.67%) one-sided posterior displacement with simultaneous anterior displacement in the contralateral joint was established with a subjective assessment of the absence of pain syndrome. Presence of a significant displacement in at least one joint was established in 72 (48.00%) patients with TMJ dysfunction, 63 (87.50%) of them had a pain syndrome. Conclusions. CT enables a comprehensive assessment of bone structures and their connection in the TMJ and is a valuable tool for planning orthopedic treatment and evaluating its effectiveness in dynamics.
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