Functional disturbances of the masticatory apparatus – diagnosis and treatment
Journal Title: Rehabilitacja Medyczna - Year 2006, Vol 10, Issue 1
Abstract
Diagnosis of the masticatory motor system functional disturbances frequently creates significant difficulties. Aside from detailed medical history and examination of a patient, precise analysis of occlusion and lower jaw movements is necessary. Routine radiological examinations of the temporo-mandibular joint reveal pathological changes of joint surfaces shape, as well as malposition of hard tissues. In cases of severe forms of dysfunction, further imaging studies should be performed (computed tomography, magnetic resonance imaging). Treatment of these dysfunctions includes many procedures. The first and important element is combating parafunctions after previously having made the patient aware of the fact of their existence. Stomatologic causal treatment aims at restoring correct intraoral (including patient's own teeth or prosthetic restoration) and extraoral (temporo-mandibular joints) relationships and restoring appropriate activity of the masticatory apparatus muscles. During the initial phase of treatment, various types of oclusion splints, relieving apparatuses and stabilising splints are used, which enable obtaining and maintaining correct position of articular disc and heads of the mandible. In cases complicated by severe pain states, appropriate pharmacological treatment is implemented. Physiotherapeutic methods are used as protective therapy. Simple methods, used even by patients themselves, include warmth-treatment (humid warmth or dry warmth) and cryotherapy. Treatment with physical agents such as electrical current, ultrasound and low-energy laser therapy is also used. Classical massage, connective tissue massage and auto-massage of the masseter muscles act adjunctively. The biofeedback method used simultaneously with passive and active exercises can also be helpful in obtaining a change in patient's behaviour,. Positive results of the therapy of the masticatory apparatus motor system dysfunctions are achieved in 60-80% of the treated patients, while prophylaxis involves mainly counteracting parafunctions of the mandible.
Authors and Affiliations
Grzegorz Kogut, Andrzej Kwolek
Keywords
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