The temporomandibular joint (TMJ) dysfunction is one of the most common dental diseases. Pursuant to the American Academy of Orofacial Pain, the TMJ dysfunction is a disease comprising the clinical pathological conditions of the muscles of mastication, TMJ and TMJ associated structures. The maxillomandibular complex is an integral component of a motor system of the body’s myofascial framework, in particular, it is closely related to the motor complex of the head and the neck (Catanzariti J.F, 2005; National Institute of Dental and Craniofacial Research, 2014). The etiology of the TMD is multifaceted, with the pathology covering biomechanical, neuromuscular, bio-sociological and anatomical factors (Chisnoiu A.M., 2015). The disease multifactorial nature presents challenges for diagnostics and determination of the main etiological factor in order to eliminate or reduce its impact. The role and the etiopathogenic influence of the occlusion impairments on the articular head displacement remain under discussion. The relationship between the craniofacial anomalies and the TMD is encompassed only by the study of the skeletal occlusion and cephalometric analysis of the parameters by various authors. The traditional methods of treatment exhibit temporal effect and rehabilitation remains incomplete.
The new theoretical and practical findings regarding TMD have been established in the thesis as based on the conducted research. The new risk factors have been found, the diagnostic criteria and the peculiarities of the therapeutic approach have been elaborated.
The aim of the study is to increase the efficacy of diagnostics, methods of pathogenic treatment of patients with craniocervicomandibular dysfunction by analyzing the objective examination findings, X-ray and functional examinations of changes in the cervico-mandibular region.
The object of the study – clinical, laboratory, functional characteristics of the craniocervicomandibular region in patients with craniocervicomandibular dysfunction.
The subject of the study – the efficacy of diagnostics and methods of treatment of patients with craniocervicomandibular dysfunction.
Pursuant to the aim and objectives set, the different variants of the articular head positions with temporomandibular joint dysfunction were investigated. Moreover, the position of the cranial bones was analyzed and the detailed assessment of the cervical spine condition, which has its peculiarities for each position of the articular heads, was conducted. Thus, the various types of craniocervicomandibular dysfunction have been described. The new risk factors for the development of the craniocervicomandibular dysfunction, which are fundamental in a primary diagnostics, were found. The therapeutic approach, considering the peculiarities of the clinical and X-ray manifestations of the craniocervicomandibular dysfunction, has been elaborated. The developed therapeutic approach was compared to the well-known ones.
The following has been applied for implementation of the objectives set: general clinical methods of examination, cephalometric analysis according to Tweed, Kim, Ricketts, Jarabak, Sassouni+, Grummons, orthopantomography, determination of axis angle on the lateral teleroentgenography [TRG], TMJ CT, electromyography of the masticatory, temporal, sternocleidomastoid and trapezius muscles. Moreover, the evaluation method by CT and TRG in frontal, lateral views, elaborated by us, has been applied for the detailed assessment of the position of the temporal, certain parts of sphenoid, occipital bones, isolated positions of the cervical vertebrae in various views (prior to and post treatment). The photos of the occlusion changes prior to, in process and post treatment were taken.
