School of Dental Medicine, University of Zagreb, Croatian Dental Society - Croatian Medical Association
Abstract
Temporomandibularne disfunkcije u svim svojim patološkim oblicima čine sve češći problem u suvremenoj stomatološkoj praksi. Sustavan pristup dijagnostici s obzirom na prikupljanje i interpretaciju podataka o pacijentu jedan je od primarnih ciljeva u tretmanu znakova i simptoma TMD-a.
Prema W. Bellu dijagnoza TMD-a mora obuhvatiti:
• pravilnu identifikaciju i klasifikaciju poremećaja
• razumijevanje mehanizma nastanka i mjesta boli
• utvrđivanje etioloških čimbenika, ako je moguće
• bazirati prognozu s obzirom na djelotvornost terapije.
Temeljem navedenih načela temporomandibularna disfunkcija ne može se smatrati jedinstvenim patološkim entitetom već skupinom bolesti koja se javlja sličnim preklapajućim simptomima. Posljedično, terapija svih oblika TMD-a nikako ne može biti ista.
Osim uobičajenih kliničkih postupaka u dijagnostici TMD-a upotrebljavaju se i računalni postupci poput elektromiografije,
elektrosonografije elektrokinetička i aksiografska mjerenja koja omogućuju da se lakše postavi pravilna dijagnoza i izabere prikladna terapija.Temporomandibular dysfunction in al its variety tends to present a problem with high morbidity and increasing prevalence in the dental office. A systematic approach to gathering and interpreting clinical evidence must be the primary goal when dealing with patients who suffer from TMD signs and symptoms.
According to W. Bell diagnosis of TMD must:
• Properly identify and classify the disorder.
• Establish the mechanism of dysfunction and the source of pain.
• Determine the etiology, if possible.
• Provide a basis prognosis in the light of effective therapy.
As a result of these principles we can canclude that TMD is not an acceptable diagnosis. It refers to a group of diseases with overlapping and similar signs and symptomatologies and cannot be solely used to determine appropriate therapy.
Apart from good clinical judgement the patient can benefit from any inanimate objective measuring device which improves the clinician’s sensory acuity. Information obtained from electomyography, electrosonography, electrokinetic and axiographic tracings analyzed properly can aid in assessing what a specific TM disorder does to
a patient and the effect treatment has on that disorder
