FUNCTIONAL DISORDERSOF THE SALIVARY GLANDS IN PATIENTS WITH COMPRESSION AND DISLOCATION DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT AND THEIR CORRECTION.

OBJECTIVE: The aim: Is to assess the functional state of parotid glands and general secretion in patients with compression, dislocation dysfunction of TMJ, to correct the revealed disorders. PATIENTS AND METHODS: Materials and methods: We examined 46 patients with dysfunction of TMJ. Examination included TMJ zonography and salivary glands sonography. We studied the general and parotid secretion, transparency, viscosity, pH of the oral fluid and the secretions of the parotid glands before and after treatment. The treatment of dysfunction and hyposialosis included the repositioning of the articular heads of the lower jaw in the correct anatomical position, the use of a repositioning plate on the posterior teeth at the compression side of the articular head, bougienage of the duct of the parotid gland, administration of 10% magnesium-mineral solution of bischofite into the gland. RESULTS: Results: In patients with TMJ dysfunction, a significant decrease in the oral fluid content was noted before treatment. The saliva transparency was reduced, the viscosity was increased, the pH was slightly acidic. A study, which was carried out a month after completion of the course of treatment showed that all the studied parameters corresponded to those in healthy individuals. CONCLUSION: Conclusions: The study confirmed that in compression and dislocation dysfunction of TMJ, there are disorders of the functional state of the salivary glands.

Hypermobility of the articular heads of the temporomandibular joint: pathology or variant of the norm?

Introduction: Among the large contingent of patients with TMJ dysfunctions, there are persons with hypermobility of the joint heads of the lower jaw. Moreover, at present, the question of the frequency of occurrence of hypermobility of articular heads of the TMJ is not reflected. The aim of the work is to find out the frequency of occurrence of hypermobility of articular head among a healthy population and to evaluate the clinical, radiological, and electromyographic characteristics of the muscular-articular complex in these individuals. Material and methods: Surveys were conducted for 476 students aged 19 to 25 years. For people with revealed articular hypermobility of the articular heads, chewing and temporal muscle electromyography, TMJ aiming zonography in a lateral projection with open and closed mouth were performed with an assessment of the correspondence of the articular fossa of the temporal bone to the size of the articular head, the location of the articular heads relative to the apex of the articular tubercle. Results: Of the examined 476 students, 95 people (20%) revealed hypermobility of the articular heads of TMJ. According to the results of clinical, functional and radiological studies of TMJ, we identified three degrees of hypermobility: light, moderately expressed, significant. With light to moderate degree of hypermobility, electromyography of the temporal and chewing muscles and TMJ zonography did not reveal a difference in performance compared to healthy ones. Most of the examined did not note functional discomfort from the joints. With a significant degree of hypermobility of the articular heads, electromyography of the temporal and chewing muscles revealed a lack of synergism in their work. On TMJ zonograms with an open mouth, the articular heads extended anteriorly beyond the tops of the articular tubercles almost under their outer base. Conclusions: It has been established that hypermobility of the joint heads of the TMJ, which does not cause signs of pathology in the form of masticatory function disorders, discoordination of the masticatory muscles and uncontrolled displacements of the lower jaw, the presence of a pain symptom should be considered as a variant of norm.

[Electromyographic characteristics of temporal and masticatory muscles in patients with compression-dislocation dysfunction of temporomandibular joints of different severity].

OBJECTIVE: Introduction: The main causes of dysfunctional conditions of the temporomandibular joints (TMJ), are occlusal, neurogenic, orthodontic disorders. The muscular component of TMJ is determines the dynamic anatomical and functional state of the mandible Therefore, in the diagnosis of dysfunctions and understanding of their pathogenesis belongs to the electromyographic method of investigation. The aim of the work was a comparative assessment of the bioelectrical activity of the actual chewing and temporal muscles in patients with musculo-articular compressiondislocation dysfunction of the TMJ of various severity. PATIENTS AND METHODS: Materials and methods: Electromyographic studies of temporal and masticatory muscles were performed in 43 patients. Was assess maximal parameters were recorded with the greatest compression of teeth and in the periods of chewing on the side of the pain symptom and on the opposite side (µV), the frequency of filling the myogram (Hz), the time of activity (Ta) and the resting time (Tc), coefficient "K", which determines the ratio of the processes of activity and rest with functional samples (K = Ta / Tc). RESULTS: Results and conclusions: The main feature of the functional properties of the studied muscles in the compression-dislocation dysfunction of the TMJ is the prevalence of the maximum indices of their bioelectrical activity on the side of the joint with the dislocation of the articular head of the mandible in comparison with the joint, which is in a compression state both during periods of compression of the teeth and mastication. This kind of discoordination in the work of the muscular masticatory apparatus is reflected in the severity of the course of dysfunction.

Investigating activity of masticatory muscles in patients with hypermobile temporomandibular joints by using EMG.

BACKGROUND: Temporomandibular joint hypermobility (TMJH) can manifest higher range of motions in mandible. The aim of this study was to investigate and compare the activity of masticatory muscle of TMJs in healthy individuals and patients with mild, moderate and severe TMJH. MATERIAL AND METHODS: In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of TMJH were included. The patients were divided into three groups based on their maximum mouth opening (MMO): (light) with MMO of 50-55 mm; (moderate) with MMO between 55 to 65 mm; and (severe) with MMO >65 mm. Also, 20 healthy people with profiled tomography in the last 6 months were invited as control group (healthy) with normal MMO (<50 mm). All the groups subjected to electromyogram (EMG) in 2 steps: maximal voluntary clenching (MVC) of the jaws; and during chewing of bread by using one side of the jaws voluntary. The collected data were analyzed by Student T-test and Chi-Square tests using SPSS software version 15 at significant level of 0.05. RESULTS: Both TMJs of light, moderate and severe groups showed significant differences in frequency, time of activity and rest in comparison with healthy group during chewing and MVC (all p values < 0.01). CONCLUSIONS: Masticatory muscles activity reduced in relation with the severity of TMJH and higher excessive mouth opening. Key words:Electromyography, joint hypermobility, mouth opening, tempormandibular joint.

Condylar distances in hypermobile temporomandibular joints of patients with excessive mouth openings by using computed tomography.

OBJECTIVES: hypermobility in Temporomandibular joint (TMJ) can manifest higher range of motions in mandible. The aim of this study was to compare the position and distances of the head of condyle to glenoid fossa in TMJs of healthy individuals and patients with mild, moderate and severe TMJ hypermobility. MATERIAL AND METHODS: In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of joint hypermobility were included and Computed tomography were administered for both TMJs. The patients were divided into three groups based on their maximum mouth opening (MMO): (A) with MMO of 50-55 mm; (B) with MMO between 55 to 65 mm; and (C) with MMO >65 mm. Also, 15 healthy people with profiled tomography in the last 6 months were assumed as control group (N) with normal MMO (<50 mm). The position of condyle from articular eminence while MMO; and the distances from anterior, superior and posterior border of condyle and facing wall of glenoid fossa were measured in closed mouth from the tomography of all contributors. The collected data were analyzed by one-way ANOVA, Post Hoc and Chi-Square tests using SPSS software version 15 at significant level of 0.05. RESULTS: The superior and posterior distances were significantly higher in groups A, B and C than healthy individuals (all P values<0.01). The anterior distance was significant between groups B and N only in right TMJ (P=0.013). CONCLUSIONS: TMJ hypermobility showed the characteristic of increased condylar distance in posterior and superior specially in higher excessive mouth opening. Key words:Computed tomography, joint hypermobility, mandibular condyle, mouth opening.