engleski

Examination of surfaces of the TMJ by dynamic manual methods

Subject of examination: An epidermiological study of craniomandibular dysfunctions (as well as tem- poromandibular disorders) was carried out on a population of younger men aged 19 -27. Active physiological movements, as well as movements compressed through dynamic methods, are not fol- lowed with sounds and pain in the temporomandibular joint. Active mandibular movements were measured together with the history data (symptoms associated with the temporomandibular joint) and tissue-specific diagnoses were made based on crepitation in clinical examination. Used method: The study comprised the subjects that in their history reported occurrence of pain in the temporomandibular joint area and pathological sound of -crepitation. Unspecific examination included -measurement of the subjects' active, movements by means of the marks on the labial inci- sor surfaces. Manual functional analysis comprised methods of dynamic compression with dynamic translations in the examination of soft tissues of the working surfaces of the temporomandibular jo- ints. The subjects with clinically established crepitation were diagnosed accordingly as having tissue- specific changes. ( Results and statistical method: In their history six subjects (3.2 %) reported positive for pain 17 (8.9 %) for crepitation for the right and left temporomandibular joint. The following are average parameters of the extent of active movements: opening 50 mm, left laterotrusion 8.8 mm, right laterotrusion 8.3 mm, protrusion 4.8 mm and retrusion 0.6 mm. Changes in soft tissues structures of the temporoman- dibular joints were established in 46 (24.2 %) subjects. Examination of occurrence of crepitation by means of dynamic manual methods indicated occurence of osteoarthrosis in 7 (3.7 %) subjects and osteoarthritis in 6 (3.2 %) subjects. Spearman's rank correlation coefficient was established (p < 0.05) for the pain and extent of certain active movements, as well as for the variables of dynamic compres- sions with translations. Conclusion: Crepitation is a reliable symptom and clinical sign of reiessive adaptation of the functional surfaces in the temporomandibular joint. Painful crepitation and crepitation without additional symp- toms is rare case in the examined population and arthrotic changes in the temporomandibular joint are associated with older age groups, especially of patients. The aim of the application of dynamic manual methods of examination is to provoke results of compensated changes in the temporomandibular joint areas in terms of early diagnosis of disorders. It is a contribution to examination of individual anatomic Istructures of the temporomandibular joint and to making a reliable tissue-specific diagnosis.

joint surfaces; dynamic methods; tissue-specific diagnosis

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