Militi Angela, Bonanno Mirjam, Calabrò Rocco Salvatore
Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy.
IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. Da Casazza, 98123 Messina, Italy.
J Clin Med. 2023 May 17;12(10):3528. doi: 10.3390/jcm12103528.
Patients affected by neurological disorders can develop stomatognathic diseases (SD) related to decreased bite force and quality of mastication, bruxism, severe clicking and other temporomandibular disorders (TMD), which deeply affect patients' swallowing, masticatory and phonation functions and, therefore, their quality of life. The diagnosis is commonly based on medical history and physical examination, paying attention to the temporomandibular joint (TMJ) range of movements, jaw sounds and mandibular lateral deviation. Diagnostic tools such as computed tomography and magnetic resonance imaging are used instead in case of equivocal findings in the anamnesis and physical evaluation. However, stomatognathic and temporomandibular functional training has not been commonly adopted in hospital settings as part of formal neurorehabilitation. This review is aimed at describing the most frequent pathophysiological patterns of SD and TMD in patients affected by neurological disorders and their rehabilitative approach, giving some clinical suggestions about their conservative treatment. We have searched and reviewed evidence published in PubMed, Google Scholar, Scopus and Cochrane Library between 2010 and 2023. After a thorough screening, we have selected ten studies referring to pathophysiological patterns of SD/TMD and the conservative rehabilitative approach in neurological disorders. Given this, the current literature is still poor and unclear about the administration of these kinds of complementary and rehabilitative approaches in neurological patients suffering from SD and/or TMD.
患有神经系统疾病的患者可能会出现与咬合力下降、咀嚼质量、磨牙症、严重弹响及其他颞下颌关节紊乱（TMD）相关的口颌系统疾病（SD），这些疾病会严重影响患者的吞咽、咀嚼和发声功能，进而影响他们的生活质量。诊断通常基于病史和体格检查，重点关注颞下颌关节（TMJ）的活动范围、颌骨声音和下颌侧向偏斜。如果在病史和体格检查中发现不明确的结果，则会使用计算机断层扫描和磁共振成像等诊断工具。然而，口颌系统和颞下颌关节功能训练在医院环境中尚未作为正式神经康复的一部分被普遍采用。本综述旨在描述患有神经系统疾病的患者中最常见的SD和TMD病理生理模式及其康复方法，并就其保守治疗提出一些临床建议。我们检索并回顾了2010年至2023年间发表在PubMed、谷歌学术、Scopus和Cochrane图书馆的证据。经过全面筛选，我们选择了十项关于神经系统疾病中SD/TMD病理生理模式和保守康复方法的研究。鉴于此，目前关于在患有SD和/或TMD的神经疾病患者中实施这类补充和康复方法的文献仍然匮乏且不明确。
