Nasibullina A. H.

Bashkir State Medical University, Ufa, Russia

RELATIONSHIP OF SYNDROME OF PAIN DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT AND PSYCHOLOGICAL STATUS OF PATIENTS

In dentistry, the problem of timely diagnostics and complex treatment of the syndrome of dysfunction of the temporomandibular joint still remains one of the most important [1,4]. Among other dental pathologies percentage of diseases of the temporomandibular joint is continuously growing.

According to the world health organization, about 40% of the population aged from 20 to 50 years suffer from muscular and articular dysfunction of the temporomandibular joint. In the structure of pathology jaw pathology, TMJ belongs to the leading position - more than 80%. Under the mean TMJ dysfunction syndrome that affects the muscles of the head and neck, the joint, and cranial nerves and ganglia. Currently there is no consensus about the nature of the dysfunction syndrome of the temporomandibular joint (DNS) [3].

Release causes that influence the occurrence of TMJ dysfunction: abnormalities in the development of tissue structures that are involved in the formation of the joint , a violation of occlusal relationships; disturbances in the musculoskeletal system, causing imbalance in the muscular corset of the whole body; hypertonicity of the masticatory muscles; chronic emotional stress, suppression of negative emotions; However, in recent years more and more researchers tend to believe about the leading role of psychoemotional status in the development of pain dysfunction syndrome. At the moment of the Genesis of mental and psychosomatic nature of TMJ disorder claim, many researchers [2,7].

Stress and emotional factors are called first causes hyperactivity of the masticatory muscles, in which there is a rapid fatigue and muscle spasm causing dysfunction of the temporomandibular joint[10].

Contemporary researchers statistically significant results before and after treatment of patients with TMJ disfunkcii, using psycho-diagnostic methods. Dental and psychological practice has already been used in the complex treatment of psychological correction: cognitive-behavioral therapy[5], psihofarmakoterapia [6]. The authors note that without the therapy of emotional disorders treatment of TMJ dysfunction is often ineffective [5].

According to the literature domestic and foreign authors, it is proved that for diagnostics of a pathology of the temporomandibular joint can be used a variety of methods and technologies such as cone-beam CT and magnetic resonance imaging, myography, the sonography. However, to date, there are no criteria for the choice of one or another technique depending on the functional and structural changes of TMJ, and there are clear indications and algorithm implementation methods of diagnostics of diseases TMJ.

At the moment there are 2 most effective and informative, not invasive methods of diagnosis of TMJ dysfunction: 1) cone-beam computed tomography (CBCT); 2) magnetic resonance imaging (MRI) of the temporomandibular joint.

When using the method of MRI it is possible to achieve early diagnosis and thereby more successful treatment of TMJ dysfunction. Also, the use of MRI allows for repeated studies after adjustments of the position of the lower jaw without fear of increasing the x-ray load on the patient.

CBCT TMJ is a very sensitive specific method for the diagnosis of morphological, degenerative and traumatic damage to the articular and bone changes. Currently, CBCT is the most common method for review of bone structures of the temporomandibular joint. Inflammatory changes, the position of the articular disc and other soft tissue structures are clearly visible only on an MRI. The combination of the two methods, we can fully evaluate the state of dentition, to make a diagnosis of TMJ disorder, how to recognize the onset of the disease and the time to begin treatment.

Thus, we can conclude that the important role in the development of pain dysfunction syndrome of the temporomandibular joint, along with occlusion-articulation disorders, play changes of psychoemotional status of patients. In the development of a painful symptom of TMJ disorder enormous role played by suprasegmental structures of the Central nervous system that are involved in shaping pain responses and changes in psycho-emotional sphere.

Literature analysis of scientific papers talking about the risk of the development of TMJ dysfunction as psychosomatic pathology, the need for a comprehensive approach to prevention, the treatment of the functional disorders dentoalveolar system.

Literature

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