Relevance and justification of the theme. The research is dedicated to the study of temporomandibular joint (TMJ) pathology, which is diagnosed in nearly 80% of the adult population and continues to increase annually. The diagnosis of this pathology is challenging due to its prolonged asymptomatic course and the absence of organic changes at the early stages of the disease, both in clinical manifestations and radiological findings
The pain phenomenon accompanying the manifestation of dysfunction is the most complex symptom in the diagnosis and treatment of TMJ disorders, as it represents a purely subjective characteristic. Patients with TMJ dysfunction complicated by myofascial pain syndrome currently constitute the most difficult-to-treat group of dental patients. Up to 98% of patients with this pathology experience complications as persistent or recurrent pain syndrome.
The peculiarity of musculoskeletal dysfunction pain lies in the fact that it lacks clear boundaries and precise localization, which significantly complicates the differential diagnosis of this condition.
The numerous and diverse methods currently known for the diagnosis and treatment of TMJ disorders have been classified and are predominantly based on the correction and stabilization of the occlusal–articulatory component. However, a number of studies focusing on the cranial–cervical–mandibular region of patients, unfortunately, do not include the neural component, disrupted neuromuscular balance, or the individual subjective perception of pain by the patient.
According to V. Santiago, even after complete restoration of occlusal relationships and elimination of pain symptoms associated with TMJ and muscle dysfunction, up to 65% of patients report recurrent pain symptoms after 5 years, with this percentage increases to 85% after 7 years, which indicates the dominant role of neural and myogenic factors in the development of dysfunction-related pathologies. Only 14% of patients experience no recurrences, which reflects their adaptive mechanisms and a positive outcome of gnathological treatment.
The primary methods of treatment for TMJ dysfunctions are often symptomatic measures that aggravate the patient’s condition at certain disease stages, but usually do not integrate the underlying pathogenetic mechanisms. In our view, the diagnosis and treatment strategy for TMJ dysfunctions complicated by pain syndrome should be based on modern methodology and objective instrumental technologies.
Recent studies by researchers have demonstrated that in 76% of patients over the age of 35, myofascial pain symptoms occur regardless of the presence or restoration of dentition defects. Therefore, a current priority in the treatment of patients with TMJ dysfunction is the theory of integrated pathogeneses, with the dominance of one or several of its components.
During the examination of patients in recent years (2022–2024), we observed a marked increase in the recurrence of pain manifestations in patients with TMJ dysfunction. In this context, the etiological factors were primarily the psychophysiological and psychosomatic components, which had a particularly pronounced impact on the neuromuscular component. All of this necessitated deeper research and the search for new diagnostic and treatment algorithms for this pathology.
The subjective symptom of pain can be assessed by a clinician only using an index-based visual analog scale, as pain is inherently an individual sensation and perception unique to each patient. Apart from test assessments, there are no studies that objectively confirm or refute the depth or intensity of pain perception experienced by a patient.
Thus, the problem of diagnosis and treatment of diseases involving the peripheral nervous system and their complications as a chronic pain syndrome is undoubtedly relevant, and the number of such patients demonstrates a steady upward trend. Conditions accompanied by pain syndrome should therefore be regarded not only as a medical, but also as a common social problem. Consequently, most currently available treatment methods for musculoskeletal dysfunction are generally based on a symptomoriented paradigm.
Today, there is a clear need to investigate, differentiate, and integrate the pathogenetic mechanisms of TMJ dysfunctions, especially those complicated by myofascial pain syndrome, in order to facilitate the development of new effective treatment algorithms. The widespread use of modern digital technologies enhances the effectiveness of diagnostic and therapeutic interventions.
The necessity to develop this field research has been stipulated for the progressing increase in the number of patients with TMJ disorders complicated by myofascial pain syndrome (MFPS), rising level of anxiety among the population, insufficient effectiveness of conventional treatment for this category of patients, as well as the need to introduce new highly effective diagnostic and therapeutic methods.
