Kupyrev I.V., Drobyshev A. Yu., Sviridov E.G. The morpho-functional state of the temporomandibular joint in patients with gnathic form of vertical incisal disocclusion. Head and neck. Russian Journal. 2021;9(1):27–37 (In Russian).
The authors are responsible for the originality of the data presented and the possibility of publishing illustrative material – tables, figures, photographs of patients.
In the modern scientific literature, the data are lacking on the morphofunctional state of the temporomandibular joint (TMJ) before orthognathic surgery in patients with the gnathic form of vertical incisal disocclusion (VID). Purpose of the study. To reveal the morphofunctional state features of the TMJ in patients with the gnathic form of VID.
Material and methods. We examined 50 patients with gnathic form of VID. All patients underwent: the collection of complaints and past medical history, clinical examination (according to the results of which, each patient had a filled comprehensive diagnostic card for functional disorders of the TMJ), computed tomography of the maxillofacial region (CT) and magnetic resonance imaging of the TMJ (MRI). All patients subsequently underwent combined orthodontic and surgical treatment.
Results. The patients enrolled in the study suffered from limited mouth opening, pain, deviation, crunching and / or clicking feeling when opening the mouth. Most often, the patients had the combination of the deviation of the lower jaw (LJ) while opening and closing the mouth with a crunch or click in the TMJ area, specifically. The combination of the rest of the listed symptoms was not observed. In 15 patients, no clinical manifestations of TMJ dysfunction were identified. Using MRI, we observed a limitation of mobility without displacement of the articular discs and destructive processes, anterior displacement of the articular discs in a position with an open mouth with or without partial reposition of the disc with a closed mouth, displacement of the condylar heads forward and upward, in addition to displacement of the discs. Besides the displacement of the condylar heads, we observed phenomena of chronic inflammation (arthritis, synovitis), dysfunction and anomaly in the shape and size of the condylar heads. In 5 patients, no pathological changes in the TMJ were revealed. With the LJ condylar head position analysis relative to the joint fossa, we found bilateral displacement of the condylar head into the articular fossa, the asymmetry of the position of the condylar heads, unilateral displacement of the condylar head into the joint fossa with normal position on the opposite side, bilateral displacement of the condylar heads downward relative to the joint fossa. The normal position was observed in 17 patients. Conclusion. As a result of the study, we argue that TMJ dysfunction and the gnathic form of VID are associated, however, no pattern has been identified for the manifestation of TMJ pathology depending on the type of dentoalveolar anomaly. Further research is needed to assess the interaction and identify etiological factors in the occurrence of TMJ pathology.
Keywords: anterior open bite, skeletal open bite, diagnosis, TMJ disorders, magnetic resonance
Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study.