Аннотация (англ)
Today, there are many opinions about the effect of occlusion on the development of the syndrome of pain dysfunction of the temporomandibular joint (TMJ SPD). In addition, due to the polyetiological nature of the disease and the complexity of the anatomical structure and function of the TMJ, there is still no unified algorithm for the examination and treatment of patients with TMJ SPD.
The aim of the study was to assess the contractile activity of the masticatory muscles at rest and maximum compression of the jaws in patients with TMJ SPD, complicated by dentoalveolar anomalies, before and after treatment with occlusal splints.
Materials and methods. The study of the bioelectric activity of the masticatory and temporal muscles by EMG was carried out in two groups of patients. The control group consisted of 20 people without symptoms of TMJ diseases and without dentoalveolar anomalies. The main group of the study included 43 patients with TMJ SPD, complicated by dentoalveolar anomalies, before and after treatment with occlusal centering splints. According to EMG data, the functional state of the temporal and masticatory muscles was assessed. The average and maximum amplitudes of bioelectric activity were assessed at rest of the mandible and in the state of maximum volitional compression of the jaws, and the symmetry of bioelectrical activity was assessed using the symmetry indices of the temporal and masticatory muscles.
Results and discussion. When analyzing the functional state of the temporal and masticatory muscles of patients with TMJ SD at rest of the mandible, spontaneous bursts and increased indicators of bioelectric activity were obtained in comparison with the control group by 1,6 times, and in the phase of maximum compression of the jaws, the functional activity was increased by 2 times. This may be due to impaired muscle contractility, an increase in the number of motor units involved in the contraction process, and a change in the synchronization of bioelectric discharges that create an imbalance in the masticatory muscles. After the treatment of patients with TMJ SD with occlusive centering splints, the maximum and average amplitudes were restored, as well as the biopotentials of the contractile activity of the masticatory and temporal muscles on both sides were aligned.
Conclusion. In patients with TMJ SD, complicated by dentoalveolar anomalies, the masseter and temporal muscles are in a state of functional overload, so we observed muscle spasm and tension. Treatment with occlusal centering splints leads to the restoration of the functional state of the muscles, coordination and symmetry of work.:
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