Telishevska Ulyana D, Telishevska Oksana D
Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Wiad Lek. 2018;71(3 pt 2):738-745.
Introduction:The problem of temporomandibular disorders (TMD) is relevant in today's world and is considered one of the most common pathologies causing nonodontogenic pain syndromes of maxillofacial region. The morbidity of temporomandibular disorders is 27 to 76% among patients who seek dental care. There is now a significant number of classifications of TMD, however, clinically convenient, morphologically and pathogenetically substantiated classification of temporomandibular joint's (TMJ) conditions has not yet been developed. Therefore, the patient's examination protocols differ substantially. The aim: To analyze and assess the quality of classifications and examination protocols for the patients with suspected TMD.
Materials and methods: A comparative analysis of 5 TMD classifications and 3 protocols for the examination of patients with suspected TMDs were performed.
Review: A comparative analysis of following TMD classifications was conducted: American Academy of Orofacial Pain, Research Diagnostic Criteria for TMD, by B.W.Neville, D.D.Damm, C.M.Allen, J.E.Bouquot, by Christian Köneke, international classification of diseases ICD-10. The analysis of the following protocols for the examination of patients with suspected TMDs was conducted: M. Helkimo index, Hamburg protocol, M. Kleinrok protocol.
Conclusions: Difficulties in interpreting diagnoses by dentists are caused by ambiguities in classifications, a considerable number of clinical entities and their construction principles. Organ principle of structure has proved to be the most convenient for clinical application. The evaluation protocols are cumbersome and duplicate each other. Owing to the lack of a common opinion about the origin and development of TMD, use of the evaluation protocols is based on the experience of dental practitioners.
引言：颞下颌关节紊乱病（TMD）问题在当今世界备受关注，被认为是导致颌面部非牙源性疼痛综合征的最常见病理状况之一。在寻求牙科治疗的患者中，颞下颌关节紊乱病的发病率为27%至76%。目前有大量TMD分类，但尚未形成临床便捷、形态学和发病机制上有充分依据的颞下颌关节（TMJ）状况分类。因此，患者的检查方案差异很大。目的：分析和评估疑似TMD患者的分类及检查方案质量。
材料与方法：对5种TMD分类和3种疑似TMD患者检查方案进行了比较分析。
综述：对以下TMD分类进行了比较分析：美国口腔颌面疼痛学会分类、TMD研究诊断标准（由B.W.内维尔、D.D.达姆、C.M.艾伦、J.E.布夸特提出）、克里斯蒂安·克内克分类、国际疾病分类ICD - 10。对以下疑似TMD患者检查方案进行了分析：M.赫尔基莫指数、汉堡方案、M.克莱恩罗克方案。
结论：分类中的模糊性、大量临床实体及其构建原则导致牙医在解读诊断时存在困难。结构的器官原则已被证明在临床应用中最为便捷。评估方案繁琐且相互重复。由于对TMD的起源和发展缺乏共识，评估方案的使用基于牙科从业者的经验。
