The rationale for the algorithm of comprehensive digital diagnosis of patients with temporomandibular disorders using an intraoral occlusal appliance

Abstract

Relevance. The study aimed to increase the effectiveness of comprehensive diagnosis and treatment of patients with TMD using an intraoral occlusal appliance.Materials and methods. All patients of the main group underwent a digital comprehensive functional examination, including TMJ magnetic resonance imaging, kinesiography, joint vibration analysis, surface myography and electrical stimulation of the masticatory muscles, followed by a bite registration of the optimal mandible position. According to the bite recorder, the models were mounted in the articulator and the intraoral occlusal appliance was fabricated. This occlusal appliance used the first-class lever principle, which acts on the condyle using a force applied to the mesial part of the canine and rests on the distal part of the upper second molar. After the diagnosis and treatment stage using an occlusal appliance, a digital comprehensive functional examinatio n was performed again.Results. Analysis of the digital comprehensive diagnosis data evidenced the restoration of the lower jaw movement, the elimination of intra-articular disorder and the normalization of the dentition functioning as a whole, using TENS appliance and an improved intraoral occlusal appliance (Patent # 273 0995, 26.08.2020) in patients with TMD.Conclusion. Treatment of patients with TMD using an intraoral occlusal appliance, which eliminates condyle compression and dislocation of the articular disc, allows restoring the lower jaw movement and the functioning of the dentition as a whole. Kinesiography at all stages of the prosthodontic treatment allows objectively monitoring the restoration of the mandibular movement pathways, taking into account time inte rvals.