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1

Ismail, Dr Intisar J., and Dr Thikra I. Hamad. "The Relationship of Tempromandibular joint disorders with Bony Exostosis in the Oral Cavity." Mustansiria Dental Journal 6, no. 2 (March 25, 2018): 164–71. http://dx.doi.org/10.32828/mdj.v6i2.451.

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The temporomandibular joint (TMJ) may be affected by inflammatory, traumatic, infectious, congenital, and developmental, as seen in other joints. However, the most common affliction of the TMJ and masticatory apparatus is a group of functional disorders with associated pain that occurs predominantly in women and was previously known as the TMJ pain dysfunction syndrome. Since 1978, there have been substantial changes in the study of etiologic factors, pathophysiology, diagnosis, and management of what are now called temporomandibular disorders (TMD).(1)The general perception that all symptoms in the head, face, and jaw region without an identifiable cause constitute a "TMJ" problem is clearly unfounded.Although some oral lesions, such as torus palatinus and torus mandibularis are normal variants, but require prompt diagnosis and sometime treatment to reduce the potential for serious complication and enhance prosthodontic treatment. The purpose of this study is to inspect the relation of TMJ dysfunction syndrome to the presence of oral exostosis, and find the prevalence of torus palatinus (TP) and torus mandibularis (TM)The sample consisted of 932 teachers, 301 males and 631 females were examined for the presence of TMD, TP and / or TM. Analysis was carried out according to age, gender, TMJ dysfunction and the presence of TP and TM.Results indicated that 123(16.1%) had at least one symptoms of TMD, where as 49 (5.3%) had TP; and 67 (7.2) had TM. The male: female prevalence ratios of TP and TM were 1: 3.42 and 1: 1.81 respectively. The results revealed that significant relationship between TMD and tori, and increase in percentage of mandibular tori with the presence of TMJ dysfunctional syndrome more than maxillary tori were found.TP and TM were more frequent in females and there is significant relation between the TP and TM with presence of TMJ dysfunction syndrome ( P< 0.05 ) especially TM , the presence of TM might be useful to look for sign of dysfunction.
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2

Dreiman, Bernard B. "Thoughts on the psychological component of TMJ/TMD syndrome." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 112, no. 5 (November 2011): 555–56. http://dx.doi.org/10.1016/j.tripleo.2011.07.012.

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3

Graber, T. M. "Chronic pain and TMJ syndrome." American Journal of Orthodontics 87, no. 1 (January 1985): 85. http://dx.doi.org/10.1016/0002-9416(85)90185-x.

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4

Doerrer, Amy, and Frances Figart. "TMJ Syndrome: Is It Compensable?" Rehabilitation Nursing 16, no. 1 (January 2, 1991): 23–26. http://dx.doi.org/10.1002/j.2048-7940.1991.tb01168.x.

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5

Stahl, Shalom, and Edward Calif. "Carpal Tunnel Syndrome and TMJ Arthritis." Journal of Hand Surgery 30, no. 4 (July 2005): 867–68. http://dx.doi.org/10.1016/j.jhsa.2005.02.013.

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6

Ferry, Andrew M., Han Zhuang Beh, Lauren A. Truong, Rami P. Dibbs, Lesley W. Davies, Kristin Stevens, John O. Wirthlin, David M. Alfi, and Edward P. Buchanan. "Management of Bilateral Temporomandibular Joint Ankylosis and Class 2 Malocclusion in a Patient With Nager Syndrome." FACE 2, no. 4 (October 27, 2021): 484–89. http://dx.doi.org/10.1177/27325016211055789.

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Nager syndrome is a rare hereditary syndrome characterized by severe mandibulofacial and pre-axial upper limb anomalies. Patients with Nager syndrome often exhibit syndromic Pierre-Robin sequence secondary to their hypoplastic mandible and require mandibular distraction osteogenesis to prevent dependence on a tracheostomy or gastric tube. This procedure, however, has been associated with temporomandibular joint (TMJ) ankylosis. TMJ ankylosis is a highly debilitating condition that dramatically impairs patients’ function and can result in facial asymmetry in affected children during periods of rapid facial growth. Surgical intervention is warranted in patients who fail physiotherapy; however, there is no gold standard treatment for surgically correcting TMJ ankylosis in patients with Nager syndrome. Herein, we detail the surgical management of TMJ ankylosis and class 2 malocclusion in a patient with Nager syndrome.
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7

Mariana Lima Fernandes, Lídia Audrey Rocha Valadas Marques, Edilson Martins Rodrigues Neto, Mara Assef Leitão Lotif, Francisca Helvira Cavalcante Melo, and Raimunda Hermelinda Maia Macena. "Profile of temporomandibular disorder patients submitted to dental and physiotherapeutic treatment at a private clinic." RSBO 11, no. 3 (September 30, 2015): 260–4. http://dx.doi.org/10.21726/rsbo.v11i3.863.

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Temporomandibular disorder (TMD) is the term used in Dentistry to define the structural and disorder changes affect the physiology of the masticatory system composed of TMJ and related to musculoskeletal structures. Objective: To conduct a descriptive, transversal and documentary study aiming to determine the profile of 14 TMD patients undergoing simultaneous dental and physiotherapeutic treatment at a private practice of the city of Fortaleza-Ce. Material and methods: The following instruments for the collection of the data were employed: files registering the evaluation and evolution, findings of the radiographic examinations and forms. Data were statistically analyzed through SPSS software, version 10.0. Results: Most of the sample was composed by females aged 32 years (+/-10.60) in average, mainly complaining about chronic headache, masticatory myalgia , TMJ pain, cervicalgy, otalgia, among others. The complete sample presented, at least, one pathology associated to and/or concomitant to TMD. The radiographic findings showed TMJ alterations and tooth losses. Analgesics were the most used drugs. Conclusion: TMD is a complex syndrome, with many etiologies and symptoms, aggravating and perpetuating factors, requiring multiple and even more specialized therapeutic management attempting treatment success.
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8

Vallerand, April Hazard, Mildred M. Russin, and Warren Paul Vallerand. "Taking the Bite out of TMJ Syndrome." American Journal of Nursing 89, no. 5 (May 1989): 688. http://dx.doi.org/10.2307/3470767.

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9

VALLERAND, APRIL HAZARD, MILDRED M. RUSSIN, and WARREN PAUL VALLERAND. "TAKING THE BITE OUT OF TMJ SYNDROME." AJN, American Journal of Nursing 89, no. 5 (May 1989): 688–90. http://dx.doi.org/10.1097/00000446-198905000-00024.

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10

Yasuda, T., H. D. Nah, J. Laurita, T. Kinumatsu, Y. Shibukawa, T. Shibutani, N. Minugh-Purvis, M. Pacifici, and E. Koyama. "Muenke Syndrome Mutation, FgfR3P244R, Causes TMJ Defects." Journal of Dental Research 91, no. 7 (May 23, 2012): 683–89. http://dx.doi.org/10.1177/0022034512449170.

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Muenke syndrome is characterized by various craniofacial deformities and is caused by an autosomal-dominant activating mutation in fibroblast growth factor receptor 3 ( FGFR3P250R). Here, using mice carrying a corresponding mutation ( FgfR3P244R), we determined whether the mutation affects temporomandibular joint (TMJ) development and growth. In situ hybridization showed that FgfR3 was expressed in condylar chondroprogenitors and maturing chondrocytes that also expressed the Indian hedgehog (Ihh) receptor and transcriptional target Patched 1( Ptch1). In FgfR3P244R mutants, the condyles displayed reduced levels of Ihh expression, H4C-positive proliferating chondroprogenitors, and collagen type II- and type X-expressing chondrocytes. Primary bone spongiosa formation was also disturbed and was accompanied by increased osteoclastic activity and reduced trabecular bone formation. Treatment of wild-type condylar explants with recombinant FGF2/FGF9 decreased Ptch1 and PTHrP expression in superficial/polymorphic layers and proliferation in chondroprogenitors. We also observed early degenerative changes of condylar articular cartilage, abnormal development of the articular eminence/glenoid fossa in the TMJ, and fusion of the articular disc. Analysis of our data indicates that the activating FgfR3P244R mutation disturbs TMJ developmental processes, likely by reducing hedgehog signaling and endochondral ossification. We suggest that a balance between FGF and hedgehog signaling pathways is critical for the integrity of TMJ development and for the maintenance of cellular organization.
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11

Takamatsu, Koki, Hitoshi Sato, Takashi Moriya, Arisa Yasuda, Takaaki Kamatani, and Tatsuo Shirota. "Long-Term Follow-Up of SAPHO Syndrome for 15 Years Led to a Diagnosis of Temporomandibular Joint Pain and Trismus." Case Reports in Dentistry 2021 (November 26, 2021): 1–6. http://dx.doi.org/10.1155/2021/3102037.

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Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a systemic disease with symptoms of pustular skin disease and sterile osteoarticular lesions. This disease rarely involves the temporomandibular joint (TMJ). Although it is a disease with a good long-term prognosis, its treatment remains challenging. We describe a case with long-term follow-up of SAPHO syndrome for 15 years in which TMJ pain and trismus led to the diagnosis. A 30-year-old woman with TMJ pain and trismus was referred to our department. Her medical history included palmoplantar pustulosis. Sterile inflammation in the left TMJ and diffuse sclerosing osteomyelitis of the mandible were observed. Thus, she was diagnosed with SAPHO syndrome. The symptoms of severe TMJ pain, trismus, and left cheek swelling presented three times in the 15 years. Symptomatic treatment with nonsteroidal anti-inflammatory drugs, antibiotics, corticosteroids, and bisphosphonates was administered several times. There has been no relapse of symptoms over the past nine years. The patient must be continuously kept under observation to look for the relapse of symptoms.
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12

Okoh, M., N. Onyia, O. Azeez, and DS Okoh. "A Facility-Based Study of Severity of Pain Among Patients with Temporomandibular Myofascial Pain Syndrome." Annals of Health Research 6, no. 4 (November 24, 2020): 402–9. http://dx.doi.org/10.30442/ahr.0604-05-103.

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Background: Myofascial pain syndrome is the most common temporomandibular joint (TMJ) disorder. Objective: To measure pain severity among patients with temporomandibular myofascial pain syndrome using the Visual Analogue Scale (VAS), and to relate pain severity to age and gender. Methods: A cross-sectional study of patients who presented with TMJ pain and were diagnosed with TMJ myofascial pain syndrome was conducted. Data were collected using a structured questionnaire and were statistically analysed. Results: Out of a total of 603 patients, 18 (3.0%) had temporomandibular myofascial pain syndrome. They were aged 22-78 years with female preponderance (11; 61.1%) and a female-to-male ratio of 1.6:1. The majority of the patients had mild pain (7/18; 38.9%). The mean VAS score for the patients in this study was 5.8+2.6. The female patients experienced more severe pain (5/11; 45.4%), compared to males. Conclusion: There was a female preponderance in TMJ myofascial pain syndrome, with a mean VAS pain score of 5.8+2.6. Severe pain was mostly reported by female patients while the male patients often present with mild pain.
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13

Mosby, Edward L. "Condylar metastasis with initial presentation as TMJ syndrome." Journal of Oral and Maxillofacial Surgery 44, no. 10 (October 1986): 838. http://dx.doi.org/10.1016/0278-2391(86)90173-4.

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14

Mohindra, A., M. Venkatasami, and J. Green. "First bite syndrome secondary to open TMJ surgery." International Journal of Oral and Maxillofacial Surgery 44 (October 2015): e264. http://dx.doi.org/10.1016/j.ijom.2015.08.245.

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15

Khaybullina, R. R., L. P. Gerasimova, and N. S. Kuznetsova. "DIAGNOSIS AND TREATMENT OF PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS AND MUSCULAR-ARTICULAR DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT PAIN SYNDROME." Russian Journal of Dentistry 21, no. 4 (August 15, 2017): 200–203. http://dx.doi.org/10.18821/1728-2802-2017-21-4-200-203.

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The article is devoted to the diagnosis and treatment of patients with musculo-articular dysfunction (MSD) of the temporomandibular joint (TMJ) pain syndrome in combination with amplipulsetherapy, fluctuating and orthopedic methods. The purpose of the study - to improve the diagnosis and treatment of patients with chronic generalized periodontitis (present study included) of the DPA and TMJ, with pain, with the help of complex methods of therapy. Made clinical examinations of 98 patients of 35-45 years with MSD and TMJ pain. Identified groups of patients with present study included and MSD with displacement and without displacement of the mandible. Defined electromyographic parameters of bioelectric activity of masticatory and temporal muscles in patients with present study included and MSD. For pain syndrome all patients appointed fluctuating in the area of TMJ. Determined the effectiveness of the treatment, studied diagnostic models in articulator PROTAR (Germany), conducted an electromyography. To eliminate occlusive barriers used mouthguard during sleep. Studies have shown that the use of clear aligners in combination with orthopedic and physiotherapeutic methods is an effective method in the treatment of patients with MDS present study included pain. Okklyuzionny tires change the nature of closing the teeth, affect the periodontium, masticatory muscles and TMJ. Without dental intervention on the occlusal surface they help to diagnose and troubleshoot the DPA in the TMJ due to occlusions violations.
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16

Ilyin, Aleksander A., T. A. Fazylova, E. A. Demchinsky, V. N. Olesova, and E. E. Olesov. "A complex treatment of irreducible displacement of the temporomandibular joint disc and myofascial pain disorders with the use of botulinum toxin." Journal of Clinical Practice 10, no. 2 (August 17, 2019): 14–20. http://dx.doi.org/10.17816/clinpract10214-20.

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Background. An irreducible displacement of the articular disc (IDD) is one of the TMJ conditions characterized by complexity of clinical manifestations, severity and is always accompanied by myofascial pain disorders. Objective. To improve the results of treatment of patients with TMJ IDD and myofascial pain syndromes. Methods. We performed a clinical examination and treatment of 38 patients with irreducible displacement of the TMJ articular disc and myofascial pain disorders. As additional research methods, we used CBCT, MRI, EMG. A step-by-step treatment was conducted, including a drug therapy, injection of botulinum toxin type A (BTA) in the masticatory, temporal, lateral pterygoid muscles (LPM) bilaterally; repositional splint therapy; arthrocentesis with the lavage of both articular spaces. Results. The overall effectiveness of the treatment was 97.4%. Out of 38 patients, 34 (89.5%) were treated without arthrocentesis with the complete restoration of the mandibular movement volume and elimination of pain syndrome. Conclusions. An effective system has been developed for a sequential complex treatment of TMJ IDD; a new technique has been developed for a periarticular injection access to the LPM allowing administration of a drug to its upper and lower heads. The high efficiency of BTA injections in the treatment of TMJ IDD is due to the mandatory drug administration into 3 muscles: masticatory, temporal and lateral pterygoid. In the treatment of TMJ IDD, arthrocentesis is effective with lavage of the lower and upper articular spaces.
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17

Ponomarev, AV V. "MATHEMATICAL MODELING IN PREDICTION OF TMJ PAIN DYSFUNCTION SYNDROME." Science and Innovations in Medicine 1, no. 2 (June 15, 2016): 38–43. http://dx.doi.org/10.35693/2500-1388-2016-0-2-38-43.

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The study presents technology of the development of formalized forecasting model of the risk group for temporomandibular pain dysfunction syndrome on the basis of a systemic analysis of multivariate rapid screening questionnaire for prevalence rate of etiological and amnesic predisposing factors and manifestations of TMJ pain dysfunction syndrome. Formalized model allows us to identify an individual consulting and diagnostic itinerary of the subject, to diagnose the cause of abnormalities in the biomechanical system, to conduct timely correction, and to start the treatment. Aim - development of affordable formal risk prediction method for predicting the development of TMJ pain dysfunction syndrome. Materials and methods. The subjects of the study were 94 respondents, 34 men and 60 women aged from 18 to 57 years, chosen by accidental sampling. The following methods were used: sociological (rapid screening questionnaire), systemic multivariate analysis, regression analysis, mathematical modeling. The study was conducted with consistent integration of rapid screening questionnaire data of clinically healthy research subjects and those with signs of TMJ dysfunction, who did not complain and did not seek dental advice concerning the changes in the TMJ. Integration was carried out by multivariate systemic analysis of personal data and the assessment of changes in the dentition of all the subjects of the sampling. The two components were taken into account in the survey system corresponding to the two data blocks: "causes" and "effects". Information from the subjects of study was obtained by the principle of dichotomous presentation, during which the test subjects noticed the presence or absence of a specific sign (symptom) in the dentition. Results. Boundary values of the integral system status indicator (min Xbi = 0,04 + 0,01, max 0,11 + 0,04) were calculated, whereby the test subject can be attributed to the risk group for the causes and predisposing factors or the first manifestation of symptoms of TMJ pain dysfunction syndrome. Conclusion. The subjects of the research with the values of the integral index falling within the confidence interval boundary values of the modified system (from Xbi = 0,04 ± 0,01 to Xbi = 0,11 ± 0,04) require determination of an individual trajectory of system correction.
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18

Wenstrup, Susie, Harpreet Singh, and Sabrina Arora. "What are effective treatments for temporomandibular joint (TMJ) syndrome?" Evidence-Based Practice 20, no. 12 (December 2017): E11. http://dx.doi.org/10.1097/01.ebp.0000541919.11833.d3.

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19

Cariati, Paolo, Blas Garcia Medina, Pablo Galvez, Almudena Cabello Serrano, Miguel Garcia Martin, and Guillermo Valencia Moya. "Arthroscopic Eminoplasty of Temporomandibular Joint: Surgical Technique." Craniomaxillofacial Trauma & Reconstruction 11, no. 2 (June 2018): 161–64. http://dx.doi.org/10.1055/s-0038-1639349.

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Temporomandibular joint (TMJ) is one of the most used joint of the body. Moreover, it is common knowledge that TMJ may show degenerative changes 10 years earlier than other joints. Recently, the use of arthroscopic surgery is revolutionizing the classic management of TMJ pathologies. In fact, the minimal invasiveness of this procedure allows faster results and fewer complications than other procedures. In this article, we present our arthroscopic technique. In this line, we would like to emphasize that we used this approach in different temporomandibular disorders such as anchored disk syndrome, habitual dislocation of TMJ, and internal derangement. Furthermore, we wish to underline that our efforts have been rewarded with great results.
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20

Melnyk, V. L., V. K. Shevchenko, and Yu I. Sylenko. "POSITION OF THE TEMPOROMANDIBULAR JOINT DYSFUNCTION SYNDROME AMONG FACIAL PAIN SYNDROMES." Ukrainian Dental Almanac, no. 1 (March 21, 2018): 79–82. http://dx.doi.org/10.31718/2409-0255.1.2018.19.

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At the present time, the actual problem of dentistry is the study of the issues of the syndrome of pain dysfunction (SPD) of the temporomandibular joint (TMJ), which is found in 14-20% of teenagers and significantly increases with age (Siemkin V.A, Rabukhina N.A., 2000 ; Khavatova VA, 2005). The pathology of TMJ dysfunction was detected in 80% of the examined patients (Bezrukov V.M, 2002). Separately allocated dysfunction of TMJ in dysplastic-dependent form of joint pathology, thereby emphasizing that dysfunction is a characteristic manifestation of dysplasia of connective tissue in the maxillofacial area (Statovskaia Ye.Ye, 2005; Kozlov D.L., Viazmin A.Y., 2007). According to observations of A.I Mirza, I.V. Mikheieva, V.M. Novikov and according to our data, in more than 90% of people, pathological phenomena in the area of the temporomandibular joint have nothing to do with the inflammatory processes of this combination. At the same time, various dysfunctions and pain spasm of separate areas of chewing muscles occupy the main place. The aim of the work was to analyze the causes and clinical symptoms of patients with SPD. In this regard, as it turned out from the anamnesis, many patients had been undergoing inappropriate treatment for a long time. The cavity of the temporomandibular joint was repeatedly injected emulsion hydrocortisone acetate, antibiotics and other medications, which do not work in case of SPD of the temporomandibular joint. In some cases, after such therapy, dysfunction of the mandible occurred, leading to an even greater disruption of the joint function and increased pain. A number of patients with SPD of the temporomandibular joint due to a false diagnosis for a long time received treatment for neuralgia of the trigeminal nerve by drugs, Novocain blockade or alcoholization of sensitive branches of the trigeminal nerve. These patients often had neuritis, which greatly worsened the patient’s condition and the prognosis of the disease. The clinical picture of the SPD of the temporomandibular joint and a number of such diseases (syndromes of Slider, Sikara, etc.) is often so obscure and confusing that a large clinical experience is needed to evaluate individual symptoms. In addition, it should be noted that dysfunction of the mandible occurs with lesions of any part of the temporomandibular complex. Thus, limitation of the mobility of the mandible usually develops with arthritis of the temporomandibular joint, abscesses and phlegmons of the parotideomasseterica, temporal regions, pterygomandibulare, parapharingenal space, jaw-tongue groove and osteomyelitis of the branches of the mandible. Diagnostic difficulties often increase due to the fact that it is not always possible to find out the atypical etiological origin of the SPD of the temporomandibular joint. Against the background of the listed objective adverse factors, the presence of diagnostic errors largely contributes to insufficient knowledge of dentists who have clinical questions and questions on treatment of the SPD TMJ due to the difficulty in differential diagnosis, which is not fully covered in textbooks on dentistry. Control of correctness of the established diagnosis is the blockade of the motor branches of the trigeminal nerve subcutaneously using the Yehorov's method, which results in the removal of muscle spasm, stops pain and improves the mobility of the mandible. Conducting additional paraclinical examination methods such as dynamic MRT, 3-D MRT, CT and electromyography should be done.
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21

Fakri, Ahmed, Youssef Halhoul, Brahim Chikhi, Loukman El Wartiti, Adam Benbachir, Abderrahmane El Wali, and Mustapha Bensghir. "LUXATION DE LARTICULATION TEMPOROMANDIBULAIRE LORS DUNE ANESTHESIE GENERALE : A PROPOS DUN CAS." International Journal of Advanced Research 10, no. 08 (August 31, 2022): 859–64. http://dx.doi.org/10.21474/ijar01/15244.

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The incidence of temporomandibular joint (TMJ) dislocation in anaesthesia is poorly reported. Patients with a history of TMJ dislocation, algodysfunctional syndrome of the mandatory apparatus or retro mandibular facial dysmorphosis are predisposed to this complication. We report a case of TMJ dislocation, diagnosed just after a general anaesthesia for a vicious callus of a humeral palette fracture in a patient without risk factors for this dislocation. The patient had a normal pre-anaesthetic clinical exam. The clinical diagnosis is simple. Its reduction is an emergency which can be performed with or without sedation by any practitioner familiar with the Nelaton manoeuvre.
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22

Lamey, P. J., and S. C. Barclay. "Clinical Effectiveness of Occlusal Splint Therapy in Patients with Classical Migraine." Scottish Medical Journal 32, no. 1 (February 1987): 11–12. http://dx.doi.org/10.1177/003693308703200105.

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A clinically similar entity to classical migraine is seen in certain dental patients suffering from temporomandibular joint (TMJ) pain dysfunction syndrome. Patients selected for study gave symptoms of classical migraine on waking. Facial pain on waking is typical of some cases of TMJ dysfunction syndrome and the hypothesis was tested that some patients with symptoms of classical migraine were at the extreme end of the spectrum of dysfunction syndrome. However, rather than experience muscle or temporomandibular joint pain these patients had symptoms on waking which were typical of classical migraine. Nineteen patients with migraine symptoms were provided with acrylic occlusal splints for nocturnal wear. A good clinical response with considerable reduction in frequency and severity of pain attacks was achieved.
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23

Opris, Horia, Mihaela Baciut, Simion Bran, Florin Onisor, Oana Almasan, Avram Manea, Tiberiu Tamas, et al. "Lateral Cephalometric Analytical Uses for Temporomandibular Joint Disorders: The Importance of Cervical Posture and Hyoid Position." International Journal of Environmental Research and Public Health 19, no. 17 (September 4, 2022): 11077. http://dx.doi.org/10.3390/ijerph191711077.

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The temporomandibular joint disorder (TMD) is a syndrome that affects the masticatory muscles and temporomandibular joint (TMJ). Its pathophysiology is not yet fully known. Cephalometric analysis is used for routine evaluation regarding orthodontic treatment and other purposes. The aim of this study was to assess if using cephalometric analysis and TMJ conservative therapy to evaluate the hyoid bone position and the cervical posture reduced symptoms in adults with TMDs compared to no intervention. The authors conducted a systematic review of the literature (PubMed, Cochrane, Web of Science, Scopus, and Embase) for clinical studies of TMDs with conservative treatment and lateral cephalometric analysis of the hyoid and cervical posture. To assess the risk of bias for non-randomized clinical trials ROBINS-I tool was used. Out of 137 studies found, 6 remained to be included. Most of them found a link between TMD and lateral cephalometric analysis, but there was a high risk of bias. This review found a possible link between TMDs, the neck and cervical posture. There is a benefit reported regarding the use of the lateral cephalometry as a treatment, but more extensive prospective randomized clinical trials are necessary to be able to draw definitive conclusions.
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24

Ohno, Hideo, Shuichi Nakamura, Ichiro Semba, Kazunori Abe, and Takao Ogawa. "An Epidemiological Study of TMJ Dysfunction Syndrome in Nepali Adolescents." Journal of the Kyushu Dental Society 48, no. 1 (1994): 29–35. http://dx.doi.org/10.2504/kds.48.29_1.

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25

Jerjes, Waseem, Tahwinder Upile, Priya Shah, Syedda Abbas, Anna Vincent, and Colin Hopper. "TMJ arthroscopy in patients with Ehlers Danlos syndrome: case series." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 110, no. 2 (August 2010): e12-e20. http://dx.doi.org/10.1016/j.tripleo.2010.03.024.

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26

Messina, Giuseppe. "The role of the styloid apophysis of the temporal bone in the biomechanics of the tongue, mandible, hyoid system: a case study." European Journal of Translational Myology 30, no. 1 (April 1, 2020): 111–15. http://dx.doi.org/10.4081/ejtm.2019.8808.

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Temporomandibular disorders are characterized by ear pain, tinnitus, difficulty in chewing, dysphagia and also dizziness, cervical limitation of range of movement (ROM) and other less common disorders. Numerous recent studies associate the presence of these signs and symptoms with an elongated styloid apophysis, as in the case of Eagle syndrome. The purpose of this clinical case is to support the thesis of a common syndrome that temporomandibular joint (TMJ) disorders with an elongated styloid process affirming the relationship between temporal bone, mandibule, hyoid bone and tongue. The patient was a 57-year-old woman who reported having ear algia and tinnitus all on the right side with difficulty chewing accompanied by odynophagia and dysphagia of solid and liquid foods, as well as cervical disorders. Computed tomography (CT) scans of the neck showed elongation and ossification of the styloid processes of the temporal bone. Magnetic resonance imaging (MRI) showed an anterior right dislocation of the TMJ articular disc. The patient presented classic symptoms of temporomandibular disorders, with the primary examinations showing an anterior right dislocation of the articular disc of the TMJ, as well as a longer styloid process on the same side. We therefore suggested that, in this case report, TMJ disorders may be associated with a longer styloid process on the same side.
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27

Lapteva, А. А., Yu А. Bystrova, А. G. Bystrov, and V. V. Partyshko. "Differential diagnosis of Costen's syndrome and cerebellopontine angle tumours." Parodontologiya 26, no. 3 (November 4, 2021): 251–55. http://dx.doi.org/10.33925/1683-3759-2021-26-3-251-255.

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Relevance. Our study aimed to determine the main differential diagnosis criteria for temporomandibular joint (TMJ) pain dysfunction syndrome (temporomandibular disorders, Costen's syndrome) and cerebellopontine angle tumours.Materials and methods. We examined 22 people (19 women and three men), aged 21 to 74 years (mean age 37.2 ± 5.1 years), who presented to the prosthodontic clinic with facial pain.Results. The study proposed the following differential diagnostic criteria for TMJ pain dysfunction syndrome and brain tumors: different nature of pain, unilateral ear noise; distal displacement of the mandibular head diagnosed by cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI), as well as articular disc displacement (detected by MRI) in temporomandibular disorders. Unilateral facial burning pain indicated meningioma of the cerebellopontine angle, which head MRI confirmed.Conclusion. The proposed table for evaluating clinical and paraclinical study methods for patients with facial pain helps to differentiate the cause of pain properly and proceed with the optimal treatment method.
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Gafforov Sunnatullo Amrulloevich and Astanov Otabek Mirjonovich. ""Differential diagnosis of patients with temporomandibular joint pain dysfunction syndromes"." International Journal on Integrated Education 3, no. 9 (September 26, 2020): 229–34. http://dx.doi.org/10.31149/ijie.v3i9.634.

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The article presents the results of a study of a specially developed map proposed by the authors in 84 patients with TMJ DM aged from 20 to 60 years, and 36 patients without TMJ dysfunction were selected as a control. According to the results of the study, the authors found that the main number of patients accounted for 59.6% after 40 years and among women - 61.9% of cases; also found in patients 46.42% occlusive-articulatory syndrome, 33.33% neuromuscular syndrome and 20.23% dislocation of the intra-articular disc; that the relationship between the amplitude of the vertical movement of the lower jaw, changes in the bioelectric potential of the masticatory muscle and the occurrence of these pathologies
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S.I., Kirsanov. "PAINFUL TEMPOROMANDIBULAR DISORDERS ARE AN URGENT HEALTHCARE PROBLEM." Natural resources of the Earth and environmental protection 2, no. 1 (March 5, 2021): 18–22. http://dx.doi.org/10.26787/nydha-2713-203x-2021-2-1-18-22.

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Despite nearly a century of research on diseases affecting the temporomandibular joint (TMJ), masticatory muscles and associated structures, this problem still remains open. Pain syndrome caused by TMJ diseases ranks first in terms of prevalence among non-odontogenic pain syn-dromes in the maxillofacial region and leads to a signifi-cant deterioration in the quality of life of patients. The high prevalence of these diseases in female patients and the presence of a number of factors of a somatic, psycho-logical and social nature, contributing to such a high prevalence, indicate the need for more close attention of researchers to these aspects, which can become a way to develop new effective methods for the diagnosis and treatment of TMJ diseases in this category of patients. A review of scientific literature was carried out in order to identify topical scientific issues related to the study, di-agnosis and treatment of TMJ diseases.
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Makeev, V. F., Yu O. Rybert, V. Ya Shybinskyy, N. R. Kliuchkovska, and O. S. Kyrmanov. "FEATURES OF OCCLUSAL THERAPY IN FUNCTIONAL DISORDERS OF TEMPOROMANDIBULAR JOINTS." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 20, no. 3 (November 12, 2020): 249–57. http://dx.doi.org/10.31718/2077-1096.20.3.249.

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Temporomandibular joint (TMJ) dysfunctions are known as being highly prevalent, having multifactorial etiology, progressive course, and high recurrence rate. This combination of features typical of this pathology places it among pressing medical issues nowadays. The variety of concepts and approaches to the analysis of the etiopathogenesis of TMJ dysfunction causes a particular interest in both highly informative diagnostic techniques and functional methods of treatment. A complex pathological morphofunctional syndrome involving parafunctions of masticatory muscles, dysfunctional TMJ states and occlusal disorders ultimately leads to deformation and a low functional disproportion in the TMJ kinetics. The work analyzes the reports on the research of various occlusal splints, and in particular, the mechanism of their action, classification of their effectiveness in various types of TMJ disorders, advantages, and disadvantages of splints, as well as materials used for their manufacturing. It is important to emphasize that the choice of the optimal therapeutic approach to internal TMJ disorders should be chosen taking into account the position of the mandibular condyle, the nature of the articular disk displacement, the presence or absence of pain, its possible causes, and concomitant local and general aggravating factors. The study was performed as a part of the research project of the Department of Orthopaedic Dentistry, Danylo Halytskyi Lviv National Medical University.
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Защихин, Е., E. Zashchikhin, О. Орешака, O. Oreshaka, А. Ганисик, and A. Ganisik. "COMPLEX DENTAL REHABILITATION OF THE PATIENT WITH BURNING MOUTH SYNDROME (CLINICAL CASE )." Actual problems in dentistry 11, no. 1 (February 25, 2015): 44–46. http://dx.doi.org/10.18481/2077-7566-2015-0-1-44-46.

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<p>The results of complex treatment patient with burning mouth syndrome are in the article. Method includes 2steps treatment using splint and then rational prosthetics done under multislice tomography of TMJ control.</p>
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32

Checherita, Laura Elisabeta, Elena Rezus, Maria Magdalena Leon, Ovidiu Stamatin, and Elena Mihaela Carausu. "Impact of Medication with Diclofenac Sodium vs. Etoricoxibum in Patients with Inflammatory Reumatic Pathology, Prosthetic Complications and Algo-dysfunctional Syndrome." Revista de Chimie 68, no. 5 (June 15, 2017): 977–81. http://dx.doi.org/10.37358/rc.17.5.5594.

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Affections of temporomandibular joint (TMJ) can lead to imbalances and disfunctions named algodisfunctional syndrome. One of the affections that we will take into consideration in this study is the temporal-mandibular arthrosis, which is, in fact, the frequent pathology at this level, and to which we will measure the pain before and after the administration of the anti-inflammatory therapy: Etoricoxib vs. Dyclofenac.The important objective of this study is to investigate this type of drug treatment over TMJ. The class of drug called non-steroidal anti-inflammatory drugs (NSAIDs)�so called to distinguish this class of drug from steroids, which have similar but additional effects�make NSAIDs one of frequently used drugs for the symptomatic treatment of many common conditions. Etoricoxib is clinically effective in the therapy of TMJ providing a magnitude of effect comparable to that of the maximum recommended daily dose of Diclofenac.
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Bertolucci, Lawrence. "Speculative Explanation of Scalenus Peripheral Nerve Entrapment Syndrome after TMJ Arthroplasty." CRANIO® 7, no. 4 (October 1989): 293–99. http://dx.doi.org/10.1080/08869634.1989.11746269.

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34

Jerjes, W., T. Upile, P. Shah, S. Abbas, A. Vincent, and C. Hopper. "P102 TMJ arthroscopy in patients with Ehlers Danlos Syndrome: case series." British Journal of Oral and Maxillofacial Surgery 48 (May 2010): S50. http://dx.doi.org/10.1016/s0266-4356(10)60191-x.

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35

Graber, T. M. "Myofascial pain as a main symptom of TMJ dysfunction pain syndrome." American Journal of Orthodontics 87, no. 3 (March 1985): 261. http://dx.doi.org/10.1016/0002-9416(85)90055-7.

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36

Xu-chen, MA, Zhen-kang Zhang, Zhao-ju Zou, Gang Zhang, and Zu-yang Zhang. "Digital subtraction arthrography and arthrofluoroscopic dynamic observations on TMJ dysfunction syndrome." Oral Radiology 6, no. 2 (December 1990): 29–35. http://dx.doi.org/10.1007/bf02352578.

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37

Maciel, Ana Lúcia Athayde, Maria Cláudia Irigoyen, and Silvia Goldmeier. "Diagnostic Accuracy of Prehospital Tele-Electrocardiography in Acute Coronary Syndrome." Telemedicine and e-Health 25, no. 3 (March 2019): 199–204. http://dx.doi.org/10.1089/tmj.2017.0277.

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38

Fazylova, Tatiana A., Alexander A. Ilyin, Valentina N. Olesova, Egor E. Olesov, Boris M. Radzishevsky, and Vagarshak G. Movsesyan. "Retrospective analysis of the treatment of internal disorders of the temporomandibular joint and myofascial pain disorders in the conditions of adult orthodontic reception." Russian Journal of Dentistry 26, no. 2 (September 4, 2022): 147–56. http://dx.doi.org/10.17816/1728-2802-2022-26-2-147-156.

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BACKGROUND: Internal disorders of the temporomandibular joint (VN TMJ) occur at orthodontic reception no less often than with other types of dental treatment. The main clinical manifestations of VN TMJ are caused by variants of anterior displacement of the articular disc, pathology of the capsular ligamentous apparatus, hypermobility of the mandibular head, and dysfunction of the masticatory muscles. The main symptom of VN TMJ is joint pain (arthralgia) and muscle pain (myalgia). VN TMJ occupies a special place in orthodontic treatment. They can be detected at the initial treatment, and their symptoms can appear at any stage of orthodontic treatment and be a complete surprise for the doctor and the patient, arise after orthodontics, and be associated with it. Since VN TMJ significantly affects the therapeutic process, its outcomes, prognoses, and treatment problems are under the close influence of orthodontists. AIM: To examine the effectiveness of the treatment of VN TMJ and myofascial pain disorders in patients with dental anomalies. MATERIAL AND METHODS: The study retrospectively analyzed case histories of 300 adult patients with dental anomalies in need of orthodontics who underwent examination and treatment in a multidisciplinary dental clinic between 2014 and 2016. The prevalence and structure of VN TMJ were assessed, and myofascial pain disorders (MFDB) and results of their correction were analyzed. RESULTS: A total of 146 (71.5%) patients with myofascial pain and 58 (28.3%) with myofascial facial pain syndrome needed orthodontic treatment more often. In these patients, VN TMJ and maxillary anomalies belonging to class II according to Engle of unilateral distal occlusion, deep bite, and class I with crowding of teeth are more often detected. Internal TMJ disorders with concomitant MFDB in the form of myofascial pain were observed in 168 (82.4%) patients. Myofascial pain disorders without VN TMJ were registered in 36 (17.4%) patients. The overall effectiveness of the treatment of VN TMJ and MFBSD was 46.4% (n=78 patients). No lasting improvement was observed in 35.7% (n=60). Deterioration was registered in 17.8% (n=30). Relapses were noted in 60.7% (n=124). In the treatment of MFDB without VN TMJ, the overall effectiveness of treatment was 5.5% (n=2), stabilization in 50.0% (n=18), and deterioration in 44.4% (n=16). CONCLUSION: Myofascial facial pain is very difficult to treat. In combination with VN, TMJ creates significant and sometimes insurmountable difficulties in adult orthodontics. All this forces specialists to look for new approaches and develop effective ways to optimize orthodontic treatment in the case of TMJ pathology and myofascial pain disorders.
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Colmenero, Cesar, Rosa Esteban, Apolinar R. Albarino, and Bartolome Colmenero. "Sleep Apnoea Syndrome associated with maxillofacial abnormalities." Journal of Laryngology & Otology 105, no. 2 (February 1991): 94–100. http://dx.doi.org/10.1017/s002221510011504x.

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AbstractFour cases with Obstructive Sleep Apnoea Syndrome (OSAS) are presented. They consisted of two cases with TMJ ankylosis with micrognathia, one case with Treacher Collins Syndrome, and one case with the Long Face Syndrome.Standard and specific cephalometric parameters were obtained to detect the site of the obstruction. Polysomnographic studies yielded information regarding the patient's sleep-wake state, respiratory and cardiac functioning, pre- and post-operatively. A temporary tracheostomy corrected the symptoms in one patient but the syndrome recurred when it was closed. Surgical correction of the maxillofacial anomalies will reestablish normal sleep patterns preventing OSAS.
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Fernández-Baena, Mariano. "Management of Pain Secondary to Temporomandibular Joint Syndrome with Peripheral Nerve Stimulation." Pain Physician 2;18, no. 2;3 (March 14, 2015): E229—E236. http://dx.doi.org/10.36076/ppj/2015.18.e229.

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Background: Temporomandibular joint syndrome, or Costen syndrome, is a clinically diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint (TMJ) is supplied by the auriculotemporal nerve, a collateral branch of the mandibular nerve (the V3 branch of the trigeminal nerve). Objectives: The aim of this study is to assess the effectiveness and safety of permanent peripheral nerve stimulation to relieve TMJ pain. Study Design: This case series is a prospective study. Setting: Pain Unit of a regional universitary hospital. Methods: The study included 6 female patients with temporomandibular pain lasting from 2 to 8 years that did not respond to intraarticular local anesthetic and corticoid injections. After a positive diagnostic block test, the patients were implanted with quadripolar or octapolar leads in the affected preauricular region for a 2-week stimulation test phase, after which the leads were connected to a permanent implanted pulse generator. Results of the visual analog scale, SF-12 Health Survey, Brief Pain Inventory, and drug intake were recorded at baseline and at 4, 12, and 24 weeks after the permanent implant. Results: Five out of 6 patients experienced pain relief exceeding 80% (average 72%) and received a permanent implant. The SF-12 Health Survey results were very positive for all specific questions, especially items concerning the physical component. Patients reported returning to normal physical activity and rest at night. Four patients discontinued their analgesic medication and 1 patient reduced their gabapentin dose by 50%. Limitations: Sample size; impossibility of placebo control. Conclusion: Patients affected with TMJ syndrome who do not respond to conservative treatments may find a solution in peripheral nerve stimulation, a simple technique with a relatively low level of complications. Key words: Temporomandibular joint disorder, temporomandibular joint syndrome, Costen syndrome, peripheral nerve stimulation, auriculotemporal nerve stimulation, preauricular block, clinical safety and effectiveness, trigeminal neuralgia
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41

Moskvicheva, Svetkana, Svyatoslav Novosel'cev, and Tatjana Guseva. "POSSIBILITIES OF MANUAL TECHNIQUES IN COMPLEX REHABILITATION IN PATIENTS WITH TEMPOROMANDIBULAR JOINT MYOFASCIAL PAIN SYNDROME." Manual Therapy, no. 4 (January 24, 2023): 25–37. http://dx.doi.org/10.54504/1684-6753-2023-4-25-37.

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42

Myagkova, Natalia, and Nikolay Styazhkin. "RESULTS OF THE USE OF OCCLUSAL SPLINTS IN PATIENTS WITH TMJ PAIN DYSFUNCTION SYNDROME ACCORDING TO KINESIOGRAPHY DATA." Actual problems in dentistry 16, no. 1 (May 14, 2020): 114–20. http://dx.doi.org/10.18481/2077-7566-20-16-1-114-120.

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Subject. Syndrome of pain dysfunction of the temporomandibular joint is one of the common pathologies of TMJ. Patients with this diagnosis complain of a violation of the movements of the lower jaw, discomfort and pain in the joint. The writings of many authors contain a deep and comprehensive discussion of various aspects of this problem, and scientific justification is given that TMJ dysfunction is almost always accompanied by muscle symptoms. One method of treatment is the use of occlusal splints. In this regard, the task of determining the effectiveness of eliminating muscular-articular dysfunction using individual occlusal splints is relevant. The aim of the study was to determine the effectiveness of treatment of TMJ dysfunction with occlusal splints according to kinesiography. Methodology. The kinesiographic study on the Myotronics K7 apparatus consisted of sequentially performing functional tests (opening and closing the mouth, lower jaw movements to the side) and using the method of percutaneous electroneurostimulation. In the treatment of all patients, an occlusal positioner splint was used, which was made individually in an articulator using an interocclusal register in the neuromuscular position of the lower jaw. The average treatment period was 4.5 months with monthly adjustments to the occlusal splint. Results. As a result of treatment with the use of the occlusal splint, disturbances in the trajectory in the transverse (in 70 % of cases) and sagittal (in 65 % of cases) planes were eliminated, the position of the lower jaw in the neuromuscular position (in 100 % of cases) was normalized. Conclusions. Treatment of patients with TMJ dysfunction using individual occlusal splints is one of the most effective ways to treat this pathology.
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43

Mathew, Smitha R., Josephine Elia, Scott Penfil, and Nicholas B. Slamon. "Application of Telemedicine Technology to Facilitate Diagnosis of Pediatric Postintensive Care Syndrome." Telemedicine and e-Health 26, no. 8 (August 1, 2020): 1043–50. http://dx.doi.org/10.1089/tmj.2019.0145.

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44

Coma-del-Corral, María Jesús, María Luz Alonso-Álvarez, Marta Allende, José Cordero, Estrella Ordax, Fernando Masa, and Joaquín Terán-Santos. "Reliability of Telemedicine in the Diagnosis and Treatment of Sleep Apnea Syndrome." Telemedicine and e-Health 19, no. 1 (January 2013): 7–12. http://dx.doi.org/10.1089/tmj.2012.0007.

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45

Imshenetskaya, N. I., D. A. Lezhnev, and O. Z. Topol’nitskiy. "Temporomandibular Joint Conditions in Patients with Craniofacial Microsomia (Literature Review)." Radiology - Practice, no. 4 (August 30, 2022): 20–29. http://dx.doi.org/10.52560/2713-0118-2022-4-20-29.

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Syndromes of I and II gill arches called maxillofacial dysostoses are accompanied by damage of temporomandibular joint (TMJ). Craniofacial microsomia is one of the of maxillofacial dysostoses. This syndrome has a number of features associated with clinical manifestations which should be taken into account at steps of the diagnosis and treatment of such patients. The degree of mandibular hypoplasia in this pathology can vary from 0 to 3, and it is inversely proportional to the integrity of the articular disc on the side of the lesion. An increased mechanical load on a healthy joint leads to its dysfunction and dislocation of the articular disc at the healthy side. In addition to hypoplasia of bone structures, craniofacial microsomia is accompanied by subatrophy of masticatory muscles and that in couple leads to malocclusion and myodynamic imbalance. Before drawing up a treatment plan it is necessary to study the state of the TMJ on both sides using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). The approach to treatment should be individual, combined, staged, based on the severity of the symptom complex.
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Nagasawa, Tooru. "Rhythmicity of EMG Activity of Masticatory Muscles in Patients with TMJ Syndrome." Proceeding of Japanese Society of Stomatognathic Function 5 (1987): 139–44. http://dx.doi.org/10.7144/sgf1982.5.139.

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47

Scarsella, S., D. Di Fabio, P. Cargini, and T. Cutilli. "P.352 TMJ pain and dysfunction syndrome: Use and limits of electroacupuncture." Journal of Cranio-Maxillofacial Surgery 34 (September 2006): 221–22. http://dx.doi.org/10.1016/s1010-5182(06)60857-3.

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48

Hanson, Toni, and Rand Redfern. "Polycystic Ovarian Syndrome (PCOS), Headache and Temporomandibular Degeneration (TMJ); A Case Study." Archives of Physical Medicine and Rehabilitation 97, no. 10 (October 2016): e111. http://dx.doi.org/10.1016/j.apmr.2016.08.345.

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49

MCPhillips, A., L. M. Wolford, and D. B. Rodrigues. "SAPHO syndrome with TMJ involvement: review of the literature and case presentation." International Journal of Oral and Maxillofacial Surgery 39, no. 12 (December 2010): 1160–67. http://dx.doi.org/10.1016/j.ijom.2010.07.011.

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50

Makeev, V. F., U. D. Telyshevska, O. D. Telyshevska, and M. Yu Mykhailevych. "THE ROLE AND SIGNIFICANCE OF COSTEN’S SYNDROME IN DYSFUNCTIONAL CONDITIONS OF THE TEMPOROMANDIBULAR JOINTS." Ukrainian Dental Almanac, no. 3 (September 23, 2020): 34–39. http://dx.doi.org/10.31718/2409-0255.3.2020.06.

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Temporomandibular joint disease (TMJ) is one of the most pressing problems of modern dentistry, on the one hand, the frequency of pathology of the temporomandibular joint, and on the other hand - the complexity of diagnosis. In the medical specialty "dentistry" there is no section where there would be as many debatable and unresolved issues as in the diagnosis and treatment of diseases of the temporomandibular joints. Aim of the research. Based on the analysis of sources of scientific and medical information to determine the role and place of "Costen's syndrome" in the pathology of the temporomandibular joints. Results and discussion The term TMJ dysfunction has up to 20 synonyms: dysfunction, muscle imbalance, myofascial pain syndrome, musculoskeletal dysfunction, occlusal-articulation syndrome, cranio-mandibular TMJ dysfunction, neuromuscular and articular dysfunction. Finally, in the International Classification of Diseases (ICD-10), pain dysfunction of the temporomandibular joint has taken its place under the code K0760 with the additional name "Costen's syndrome", which is given in parentheses under the same code. Thus, such a diagnosis as "Costen's syndrome" is not excluded in the International Classification of Diseases. The first clinical symptoms and signs of TMJ were systematized in 1934 by the American otorhinolaryngologist J. Costen and included in the special literature called "Costen's syndrome". This syndrome includes: pain in the joint, which often radiates to the neck, ear, temple, nape; clicking, crunching, squeaking sound during movements of the lower jaw; trismus; hearing loss; dull pain inside and outside the ears, noise, congestion in the ears; pain and burning of the tongue; dizziness, headache on the side of the affected joint, facial pain on the type of trigeminal neuralgia. The author emphasized the great importance of pain and even singled out "mandibular neuralgia." The criteria proposed by McNeill (McNeill C.) in 1997 are somewhat different from those described in ICD-10: pain in the masticatory muscles, TMJ, or in the ear area, which is aggravated by chewing; asymmetric movements of the lower jaw; pain that does not subside for at least 3 months. The definition of the International Headache Society is similar in content. Anatomical and topographic study of the corpse material suggested the presence of a structural connection between the TMJ and the middle ear. According to some data, in 68% of cases the wedge-shaped mandibular ligament reaches the scaly-tympanic fissure and the middle ear, and in 8% of cases it is attached to the hammer. In addition, several ways of spreading inflammatory mediators from the affected TMJ to the middle and inner ear, which causes otological symptoms, have been described. It should be noted that there are certain prerequisites for the mutual influence of the structures of the cervical apparatus, middle and inner ear and upper cervical region at different levels: embryological, anatomical and physiological. At the embryological level. It is confirmed that from the first gill arch develops the upper jaw, hammer and anvil, Meckel's cartilage of the lower jaw, masticatory muscles, the muscle that tenses the eardrum, the muscle that tenses the soft palate, the anterior abdomen of the digastric muscle, glands, as well as the maxillary artery and trigeminal nerve, the branches of which innervate most of these structures. At the anatomical level. Nerve, muscle, joint and soft tissue structures of this region are located close enough and have a direct impact on each other. The location of the stony-tympanic cleft in the medial parts of the temporomandibular fossa is important for the development of pain dysfunction. At the physiological level. A child who begins to hold the head, the functional activity of the extensors and flexors of the neck gradually increases synchronously with the muscles of the floor of the mouth and masticatory muscles, combining their activity around the virtual axis of the paired temporomandibular joint. In addition, the location of the caudal spinal nucleus of the trigeminal nerve, which is involved in the innervation of the structures of the ear, temporomandibular joint and masticatory muscles at the level of the cervical segments C1-C3 creates the possibility of switching afferent impulses from the trigeminal nerve to the upper cervical system. Innervate the outer ear, neck muscles and skin of the neck and head. Also important are the internuclear connections in the brainstem, which switch signals between the vestibular and trigeminal nuclei. That is why the approach to the treatment of this pathology should be only comprehensive, including clinical assessment of the disease not only by a dentist or maxillofacial surgeon, but also a neurologist, otorhinolaryngologist, chiropractor, psychotherapist with appropriate diagnostic methods and joint management of the patient.
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