Kharkiv National Medical University, Ukraine.
Georgian Med News. 2024 May(350):127-132.
Etiologic and pathogenetic aspects cause the most contentious issue in the study of temporomandibular joint (TMJ) syndrome in childhood and adolescence. Some researchers have linked the emergence of this group of diseases with abnormal occlusion, others have more emphasis on the age characteristics of a growing organism, or rather on a number of morphological and psychomotor processes arising and ending at puberty and cause physiological abnormalities in the growing organism. The aim of the study was to improve the method of complex treatment of TMJ dysfunction in adolescence by exploring its development factors with early diagnosis methods.
We have examined by clinical and radiological methods 33 patients with TMJ syndrome disorder between the ages of 11 to 18 years, 20 of them (60.6%) girls and 13 (39.4%) boys. All examined patients complained of the presence of clicks in the joint when they open mouth widely, irregular movement of the lower jaw when opening the mouth, the periodic occurrence of unilateral pain in the joint and the ear, increasing when taking rigid and solid food, which allowed us to establish the diagnosis of the TMJ syndrome. A clinical study has focused on the survey of patients, and in some cases their parents, in order to study carefully the history of life and disease, and the patient's complaints. We have found out the factors predisposing to the disease: the presence of various bad habits, family history, trauma of the lower jaw and TMJ, errors in orthodontic treatment.
The data obtained showed that 16 (48.5%) patients had a history revealed various factors that contribute to the TMJ syndrome. The presence of various bad habits was about 38%. In addition, 13 (39.4%) patients reported the presence of emotional stress. The presence of orthodontic pathology was determined in 26 (78.8%) patients, 7 (21.2%) patients had no dentofacial disorders was not determined. The most common symptom, occurring in 27 (81.8%) patients was clicking in the joint with one or two sides, as well as excessive excursion of articular heads, occurring in 17 (51.5%) patients. A distinctive feature of TMJ syndrome manifestations in children and adolescents is relatively rare, in contrast to adults, the appearance of symptoms: pain when opening the mouth wide detected only 7 (21.2%) patients; pain in the joints - 8 (24.2%) patients; pain in the masticatory muscles - 6 (18.2%) patients.
Based on the above, the etiological factors of musculo-articular dysfunction of the TMJ in adolescence can be not only dental anomalies, but also the presence of bad habits, disproportions in the growth of the bone and muscular skeleton and hypokinetic states caused by psychophysiological responses to chronic stress. Accordingly, treatment of patients with this pathology should be comprehensive and include not only treatment of the dental system, but also be aimed at the uniform development of the musculoskeletal system in children and at eliminating bad habits and chronic stress factors.
通过探索早期诊断方法，研究颞下颌关节（TMJ）功能障碍的发展因素，以改善青少年 TMJ 功能障碍的综合治疗方法。
我们通过临床和影像学方法检查了 33 名年龄在 11 至 18 岁之间的 TMJ 综合征患者，其中 20 名（60.6%）为女孩，13 名（39.4%）为男孩。所有接受检查的患者在张口时都主诉有关节咔哒声，下颌在张口时运动不规则，关节和耳朵出现单侧疼痛，在食用硬质和固体食物时疼痛加剧，这使我们能够确立 TMJ 综合征的诊断。临床研究侧重于对患者及其父母进行调查，以仔细研究生活史和疾病史以及患者的主诉。我们发现了导致疾病的易患因素：存在各种不良习惯、家族史、下颌和 TMJ 创伤、正畸治疗错误。
获得的数据表明，16 名（48.5%）患者有各种导致 TMJ 综合征的因素病史。存在各种不良习惯的约占 38%。此外，13 名（39.4%）患者报告存在情绪压力。26 名（78.8%）患者存在正畸病理学，7 名（21.2%）患者无牙颌面疾病。最常见的症状是 27 名（81.8%）患者的关节咔哒声，单侧或双侧关节头过度运动，17 名（51.5%）患者发生这种情况。TMJ 综合征在儿童和青少年中的表现的一个显著特征是与成年人相比，症状出现相对较少：仅 7 名（21.2%）患者出现张口痛；8 名（24.2%）患者出现关节痛；6 名（18.2%）患者出现咀嚼肌痛。
基于上述情况，青少年 TMJ 肌肉骨骼功能障碍的病因因素不仅可能是牙齿异常，还可能是不良习惯、骨骼和肌肉骨骼生长比例失调以及慢性应激引起的运动不足状态。因此，治疗此类患者应全面进行，不仅要治疗牙体系统，还要针对儿童骨骼肌肉系统的整体发育，消除不良习惯和慢性应激因素。
