DOI:

10.37988/1811-153X_2023_4_42

Restoration the kinematics of mandibular movements by the method of hardware mechanotherapy in the protocol of functional rehabilitation for patients with TMJ’s diseases and myofascial pain syndrome

Authors

  • D.V. Shipika 1, PhD in Medical Sciences, associate professor of the Maxillofacial and plastic surgery Department
    ORCID: 0000-0001-6335-3311
  • A.D. Bagoviev 1, postgraduate at the Maxillofacial and plastic surgery Department
    ORCID: 0000-0001-5980-1679
  • K.A. Popova 1, postgraduate at the Maxillofacial and plastic surgery Department
  • A.E. Darkhanova 1, 5th year student
    ORCID: 0000-0002-0408-9079
  • A.Y. Drobyshev 1, PhD in Medical Sciences, full professor of the Maxillofacial and plastic surgery Department
    ORCID: 0000-0002-1710-6923
  • 1 Moscow State University of Medicine and Dentistry, 127473, Moscow, Russia

Abstract

Objectives — design an algorithm for restoring the kinematics of lower jaw movements by the method of hardware mechanotherapy, to evaluate the effectiveness of its use in patients with TMJ diseases and myofascial pain syndrome.
Materials and methods.
Thirty-four patients diagnosed with TMJ pain, limited mouth opening of up to 39 mm (the physiological norm is 40—45 mm), and internal TMJ disorders based on MRI data were treated with apparatus mechanotherapy. Pain syndrome severity, mouth opening value, and the IMPACT index (masticatory muscle hypertonicity) were measured before treatment and on the 7th, 14th, and 21st days using EMG data.
Results.
On the twenty-first day, there was a 38.7% increase of 12.2±2.3mm in mouth opening when compared to initial values. Additionally, there was an IMPACT index reduction of 502±292 μV (11.2% reduction) and a decrease of 5.0±0.5 points (99% decrease) in the severity of pain syndrome according to VAS.
Conclusion.
Based on the research’s results we can recommend the method of hardware mechanotherapy to using in the protocol of treatment of patients with reduced mouth opening, myofascial pain syndrome, TMJ diseases. Hardware mechanotherapy promotes to the speedy restoration of the physiological kinematics of the movements of the lower jaw, relief of pain syndrome and normalization of the bioelectric activity of the chewing muscles.

Key words:

mouth opening restriction, mechanotherapy, masticatory muscle trism, myofascial pain syndrome, functional rehabilitation, TMJ

For Citation

[1]
Shipika D.V., Bagoviev A.D., Popova K.A., Darkhanova A.E., Drobyshev A.Y. Restoration the kinematics of mandibular movements by the method of hardware mechanotherapy in the protocol of functional rehabilitation for patients with TMJ’s diseases and myofascial pain syndrome. Clinical Dentistry (Russia).  2024; 26 (4): 42—50. DOI: 10.37988/1811-153X_2023_4_42

References

  1. Drobyshev A.Yu. Diseases of the temporomandibular joint. M: GEOTAR-Media, 2022. Pp. 7—9, 17—25, 215—216 (In Russian).
  2. Polshina V.I., Reshetov I.V., Serova N.S., Babkova A.A., Lisavin A.A., Semyonov P.Ya., Roshchina A.V. Comprehensive radiology diagnostics in patients with temporomandibular joint (TMJ) dysfunction. Russian Electronic Journal of Radiology. 2021; 1: 88—102 (In Russian). eLIBRARY ID: 45747022
  3. Michelotti A., Parisini F., Farella M., Cimino R., Martina R. [Muscular physiotherapy in patients with temporomandibular disorders. Controlled clinical trial]. Minerva Stomatol. 2000; 49 (11—12): 541—8 (In Italian). PMID: 11345684
  4. Mishra S.K., Somkuwar S., Chowdhary R. Occlusion and temporomandibular joint disorders. In: Bhargava D. Temporomandibular joint disorders. Springer, Singapore, 2021. Pp. 133—143. DOI: 10.1007/978-981-16-2754-5_10
  5. Olesov E.E., Ekusheva E.V., Ivanov A.S., Olesova V.N., Zaslavsky R.S., Popov A.A. Features of the results of electromyography of muscles of the maxillofacial region and psychological examination in persons of stressed professions. Clinical Dentistry (Russia). 2020; 3 (95): 108—112 (In Russian). eLIBRARY ID: 44008076
  6. Shipika D.V., Ostashko A.A., Burenchev D.V., Lyan D.V., Drobyshev A.U. Clinical example of complex diagnostic and treatment of patient with temporomandibular joint internal derangements with arthroscopic surgery. Stomatology. 2021; 4: 109—116 (In Russian). eLIBRARY ID: 46390885
  7. Dubova L.V., Korkin L.V., Maximov G.V., Sokolova M.S. Recovery assessment of eccentric occlusal lower jaw movements in patients with TMJ disc disorders at the stage of splint therapy. Clinical Dentistry (Russia). 2022; 3: 54—59 (In Russian). eLIBRARY ID: 49514200
  8. Aiken A., Bouloux G., Hudgins P. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am. 2012; 20 (3): 397—412. PMID: 22877948
  9. Cholitgul W., Nishiyama H., Sasai T., Uchiyama Y., Fuchihata H., Rohlin M. Clinical and magnetic resonance imaging findings in temporomandibular joint disc displacement. Dentomaxillofac Radiol. 1997; 26 (3): 183—8. PMID: 9442605
  10. Lebedenko I.Y. Clinical methods of diagnosis of functional disorders of the dental system. M.: MEDpress-inform, 2006. 112 p. (In Russian).
  11. Silantieva E.N. Complex treatment and rehabilitation of patients with the syndrome of pain dysfunction of the temporomandibular joint. In: proceedings of “Modern Dentistry” conference. Kazan, 2017. Pp. 478—483 (In Russian). eLIBRARY ID: 30020490
  12. Wieckiewicz M., Boening K., Wiland P., Shiau Y.Y., Paradowska-Stolarz A. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain. 2015; 16: 106. PMID: 26644030
  13. Lyan D.V., Shipika D.V., Drobyshev A.Y., Alibekova S.A. Diagnostic value of the electromyography method as part of a complex algorithm for the treatment of patients with diseases of the temporomandibular joint. Russian Stomatology. 2020; 100 (3): 46—47. https://doi.org/10.17116/rosstomat20201303121
  14. Drobyshev A.Iu., Vykliuk M.V., Shipika D.V. The review of modern methods for the evaluation of the severity of syndrome of painful dysfunction of temporomandibular joints. Russian Stomatology. 2011; 5: 47—54 (In Russian). eLIBRARY ID: 20809987
  15. Trezubov V.N., Bulycheva E.A., Posokhina O.V. The study of neuromuscular disorders in patients with disorders of the temporomandibular joint complicated by parafunctions of the masticatory muscles. The Dental Institute. 2005; 4 (29): 85—89 (In Russian). eLIBRARY ID: 15267483
  16. Grachev Yu.V. Temporomandibular (myogenic and arthrogenic) facial pain. Russian Journal of Pain. 2007; 1 (14): 2—12 (In Russian). eLIBRARY ID: 9473314
  17. Sokolov M.A. Diseases and injuries of the temporomandibular joint. Moscow, 2000. 230 p. (In Russian).
  18. Okeson J.P., de Leeuw R. Differential diagnosis of temporomandibular disorders and other orofacial pain disorders. Dent Clin North Am. 2011; 55 (1): 105—20. PMID: 21094721
  19. Vitale G.J., Amato C.J., Falk H.J., Niebloom T.A. Magnetic resonance imaging of the temporomandibular joint. J N J Dent Assoc. 1990; 61 (3): 40—4. PMID: 2290097
  20. Beynarovich S.V., Filimonova O.I. Morphometric and morphological changes of the masticatory muscles in patients with temporomandibular joint dysfunction and masticatory muscles according to MR data. Clinical Dentistry (Russia). 2019; 3 (91): 46—49 (In Russian). eLIBRARY ID: 41188358
  21. Bristela M., Schmid-Schwap M., Eder J., Reichenberg G., Kundi M., Piehslinger E., Robinson S. Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition long-term results. Clin Oral Investig. 2017; 21 (1): 237—245. PMID: 27083157
  22. Bulycheva E.A., Bulycheva D.S. X-ray and anatomical features of the temporomandibular joint disorders. Clinical Dentistry (Russia). 2023; 2: 66—74 (In Russian). eLIBRARY ID: 54167528
  23. Darkhanova A.E., Shipika D.V. Restoration of the kinematics of mouth opening using openwide hardware mechanotherapy based on the biomechanics of the temporomandibular joint (TMJ) and the dental system. In: comped. “Best student article 2022”. Penza, 2022. Pp. 192—196. (In Russian). eLIBRARY ID: 48438351
  24. Peck C.C., Goulet J.P., Lobbezoo F., Schiffman E.L., Alstergren P., Anderson G.C., de Leeuw R., Jensen R., Michelotti A., Ohrbach R., Petersson A., List T. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil. 2014; 41 (1): 2—23. PMID: 24443898
  25. Ciancaglini R., Testa M., Radaelli G. Association of neck pain with symptoms of temporomandibular dysfunction in the general adult population. Scand J Rehabil Med. 1999; 31 (1): 17—22. PMID: 10229999

Received

September 10, 2023

Accepted

November 22, 2023

Published on

January 16, 2024