University of Zagreb. School of Dental Medicine. Department of Removable Prosthodontics.
Abstract
Termin koji se koristi za strukturalne i funkcijske poremećaje povezane s temporomandibularnim zglobom, žvačnim mišićima ili oboma, naziva se temporomandibularni poremećaj (TMP). Najčešći simptomi koji se javljaju u pacijenata s TMP-om ograničene su kretnje donje čeljusti i bol. Temporomandibularni poremećaji javljaju se u 15-25% nositelja gornjih i donjih potpunih proteza. Kod pacijenata koji nose gornju i donju djelomičnu protezu, temporomandibularni simptomi javljaju se dvaput češće nego u bezubih pacijenata s potpunim protezama. Dijagnostičke metode uključuju anamnezu, klinički pregled te one dodatne u obliku radiografije, MRI i artikuliranja modela. Klasifikacijski sustav koji se primjenjuje za dijagnostiku temporomandibularnih poremećaja dijeli ih na 4 skupine, a to su: poremećaji žvačnih mišića, poremećaji temporomandibularnog zgloba, kronična hipomobilnost donje čeljusti i poremećaji rasta. Najčešće primjenjivane metode u terapiji TMP-a kod nositelja proteza jesu farmakoterapija, fizikalna terapija i okluzijska terapija. Farmakoterapijski preparati koji se najčešće propisuju su nesteroidni protuupalni antireumatici, kortikosteroidi, benzodiazepini, opioidni analgetici, topikalni analgetici, antikonvulzivi i centralno djelujući muskulorelaksatori. Fizikalno-terapijske metode mogu se podijeliti u dvije skupine: modaliteti i manualne tehnike. Okluzijska terapija najčešće se provodi u obliku stabilizacijske udlage.Term used in structural and functional disorders associated with temporomandibular joint, masticatory muscles, or both is called temporomandibular disorder. Symptoms that are the most common in patients with temporomandibular disorder include limited mandibular movement and pain. Temporomandibular disorders occur in 15-25% upper and lower complete denture wearers. In upper and lower partial denture wearers symptoms occur twice as often as in edentulous patients with complete dentures. Diagnostic methods include anamnesis, clinical exam, and additional methods in terms of radiography, MRI and articulation of study models. Classification system used for diagnosis of temporomandibular disorders divides them in 4 categories: masticatory muscles disorders, temporomandibular joint disorders, chronic lower jaw hypomobility and growth disorders. Pharmacotherapy, physical therapy and occlusal therapy are the most commonly used in denture wearers. Pharmacotherapeutical drugs most commonly prescribed in therapy include nonsteroid anti-inflammatory drugs, corticosteroids, benzodiazepines, opioid analgesics, topical analgesics, anticonvulsive and centrally acting muscle relaxants. Methods of physical therapy can be divided in two categories: modalities and manual technics. The most commonly used occlusal therapy methods include stabilization splint
