[Craniomandibular disorder/dysfunction. Characteristics and disorders of the masticatory organ]. / Craniomandibularis diszfunkció. A rágószerv sajátosságai és muködési zavarai.

The practising physician often meets patients with pain located in different parts of the face and facial skull, mouth opening restriction or other motion disorder of the mandible. It is not always easy to identify and explain the cause. It is not widely known among doctors that most of these problems are due to masticatory dysfunction. There is a special group of patients showing functional disorders and there are some others who present a variety of different symptoms and visit several doctors. The masticatory organ, a functional unit of the human organism has a definite and separate task and function. In the early years of life it is capable of adaptation, while later on it tends to compensation. The authors outline the functional anatomy of the masticatory organ and the characteristics of multicausal pathology, the dynamics of the process of the disease and their interdisciplinary aspects. They discuss the basic elements of craniomandibular dysfunction. Based on the diagnostic algorithm, they summarize treatment options for masticatory function disorders. They emphasize the importance that physicians should offer treatment, especially an irreversible treatment, without a diagnosis. It occurs very often that the causes are identified after the patients become symptom-free due to treatment. The aim of this report is to help the general practitioners, dentists, neurologists, ear-nose-throat specialists, rheumatologists or any other specialists in the everyday practice who have patients with different symptoms such as pain in the skull, acoustic phenomenon of the joint or craniomandibular dysfunction.

[The therapy of masticatory organ dysfunctions (CMD)]. / Rágószervi funkciózavarok (CMD) therapiája.

The authors have been dealing with disorders of the masticatory organ (CMD) for several decades and they published their experience and summarized findings that they have gained from over 2,000 cases. They gave a summary of masticatory organ dysfunction diagnostics in 3rd issue of Fogorvosi Szemle in 2011. In their current paper they discuss the treatment of masticatory organ dysfunctions (CMD) according to the logic of diagnostic algorythm and they present it to the practising dentist. They would like to emphasize that it is not allowed to indicate any treatment especially an irreversible one, without a diagnosis. The cause of the disease can very often be identified or specified after the symptom relieving treatment. After summarizing the general treatment principles depending on the functional condition of the masticatory organ, they give a detailed explanation of systematic functional therapy, i.e., symptomatic treatment or medical treatment, physiotherapy, occlusal splint therapy and the definitive treatment that follows (such as occlusal adjustment, prosthetic rehabilitation, orthodontics and surgical intervention). They classify the occlusal instruments (splint), which are often misinterpreted or not used in the proper way in practice (and bibliography), according to indications. They outline some orthodontic anomalies in connection with the masticatory organ: on the one hand when the patient who undergoes an orthodontic treatment has a latent or manifest masticatory organ dysfunction (CMD), on the other hand when the dysfunction appears during the orthodontic treatment. Among the definitive treatment principles they emphasize the gnathological aspects of prosthetic rehabilitation. They draw attention to the maintenance therapy of patients suffering from masticatory organ dysfunction.

[Diagnosis of masticatory organ dysfunction craniomandibular system dysfunction (CMD)]. / Rágószervi funkciózavarok diagnosztikája--craniomandibularis rendszer dysfunctiója (CMD).

A practising dentist often meets pains of different location and limited ability of mouth opening, locomotor disorder, the cause of which is difficult to identify and explain. There is a particular group of patients with functional disorder who turn to several doctors with their varied and colorful symptoms. Most of these patients suffer from cranio-mandibular disfunction (CMD). You must not indicate any treatment especially not an invasive one without a diagnosis. While relieving the patient's pains, you have to determine the cause and effect. The authors suggest discussing the issue of giving a unanimous definition of masticatory organ disfunction as an interdisciplinary diagnosis which is in accord with international bibliography. They review the algorithm of diagnosis, indication of medical examination by demonstrating some typical cases. They share their experience gained during several decades of clinical practise involving about 2,000 patients.

[Primary, definitive treatment of the nasoethmoidorbital-midface-frontobasal injuries in the maxillofacial practice]. / NEO-arcközép-frontobázis sérülések primer definitív ellátása az arc-, állcsontsebészeti gyakorlatban.

Nasoethmoid-orbital (NEO) fractures are typically resulted by a drastic, forceful blow to the central aspect of the head and nose, associated injuries to adjacent structures occur and involve the midface, anterior cranial fossa and the eye. Dislocated bony parts of the nose may be impacted into the intraorbital region and lead to severe complications: cerebrospinal fluid leak, optic nerve lesion, anosmy, telecanthus and diplopy. In the complex management of the craniofacial lesions, a cooperative team-work of maxillofacial surgeon, neurosurgeon, otolaryngologist and ophthalmologist is required. The key of the surgery treatment is the actual status of the NEO structure. Stabilized nasoethmoidal fragments, midface and the watertight dura closure or plasty are basically important conditions for the ceasing of nasal liquorrhoea. Repositioning of fractured fragments, stabilization with titanium miniplates and reconstruction of bony defect using autologous bone are commonly used techniques at our practice. Between years 1995-2000, altogether 50 cases of injuries due to NEO fracture have been treated at our department of maxillofacial surgery. We report the possible combinations of traumatism, our operative methods, our supply tactics and experiences. Multiple and defect fractures of the craniofacial bones may cause irreversible deformities, chewing and nutritional disturbances. We preferred the early, primary, definitive supply, with the respect of aesthetic viewpoints with the application of streamlined operative methods like bone fixation and bone replacement. Our fundamental aim is the reduction of the patients' operative load, their nursing time and the enhancement of our operative results.

[Determination and practical application of articulator related individual functional parameters. New method of measurement: virtual articulator and face-bow]. / Artikulátorra vonatkoztatott egyéni funkciós ertékek meghatározása es gyakorlati alkalmazása. Uj módszer: virtuális artikulátor es arcív.

The aim of each occlusal surface reconstruction is to take the functionally developed biomorphologic aspects into consideration while restoring occlusal conditions. In order to fulfil these conditions, it is necessary to represent individual mandible movement as accurately as possible. In addition to physiological knowledge, it is indispensable for us to be able to simulate spatial mandible movement and determine individual parameters in an utmost precise way. By correcting projecting mistakes, the articulator should reproduce static and dynamic occlusal conditions according to reality. This is a difficult task. The advance of technology, spreading of computers and the idea of 'virtual articulator' have all helped to fulfil all these conditions by quick digital data processing instead of complicated and slow mechanical gadgets. The aim of our publication is to present the programming possibilities of the articulator of individual value belonging to the system and the advantages of the method.

[Functional investigation of the stomatognathic system attached to an ultrasound computer module]. / A stomatognath rendszer ultrahangos--számítógépes modullal kiegészitett--funkcionális vizsgálata.

The ARCUS digma "3D ultrasound navigator" is such an up-to-date diagnostic instrument which allows us to analyze the kinematics of the mandible. The equipment gives insight into the condylar and incisal points, the synchronous spatial movement of the right and left condylar points and the kinematic axis, its change of speed that can all refer to discoordination, limitation of movement, hypermobility leading to functional disorders. After taking medical and dental history, clinical examination and X-ray diagnosis we examined people (new patients) suffering from TMJ dysfunction with the ARCUS digma, too. We present some typical functional mandibular movements. We can not only rely on subjective judgements but it also provides an objective diagnosis based on numerical data. It does not replace but rather complies with the conventional methods and puts the diagnostic and therapeutical procedures known so far into a new dimension. The results demonstrate that this sort of investigation will not put an end to the necessity of traditional procedures used up till now but complete them, and at the same time it provides diagnostic surplus and it is indispensable for patients suffering from dysfunctional disorders to be treated in a modern way.

[Stomato-oncological screening test of volunteers] / Stomato-onkológiai szûrôvizsgálat önként jelentkezôkön.

OBJECTIVES: Identification and relative incidence of precancerosis and malignancies of the head and neck region and in the oral cavity. MATERIAL AND METHODS: In three counties of the western region of Hungary we physically examined pathological abnormities of healthy volunteers. Computerised examination reports and anamnestic data have been registered on data sheets. RESULTS: During examination of 5054 persons we have found 5 malignant tumours and 3.7% precancerosis (mostly leukoplakia). CONCLUSIONS: Orofacial tumours that are constantly increasing in our country account for the necessity of stomato-oncological screening test. Therefore, screening should be extended as far as possible to persons who live in poor social-economical circumstances. Persons with multiple risk factors are difficult to be reached by this screening test,therefore it is complicated to treat them at an early stage. We have found intense ignorance in connection with oral tumours and precancerosis. Oral hygiene and status are criticisable. Because of the deficiencies of methods in examination the morbidity rate of tumours in oral cavity is undoubtedly higher than the rate of the statistical data.