MAGNETIC RESONANCE IMAGRAPHY OF THE TEMPOROMANDIBULAR JOINT FOR DIAGNOSTIC PARAFUNCTIONS OF THE DENTAL SYSTEM USING A DIGITAL DEVICE T-SCAN

Abstract

Parafunctions of the dental system occupy a special position among dental diseases, due to the complexity of their diagnosis, treatment, complex and varied clinical picture. Methods for screening and monitoring patients with parafunctions remain an urgent scientific and practical task. Most often, this manifests itself unconsciously in the form of daytime or nighttime bruxism or clenching. Parafunction is one of the etiological factors of pain dysfunction of the temporomandibular joint. In the diagnosis of structural changes in the temporomandibular joint, the “gold” standard is magnetic resonance imaging. Due to the high contrast of soft tissues, magnetic resonance imaging is a method for diagnosing structural changes in the tissues of the temporomandibular joint and allows the most accurate, highly informative and quick assessment of the condition and function of intra- and extra-articular elements. In daily practice, dentists need simple and practical methods for diagnosing and parafunctional activity. Digital dentistry provides opportunities for assessing occlusal contacts. T-scan is one of the most functional digital devices. The purpose of the study was to increase the efficiency of providing dental care to patients with parafunctions by identifying the severity of bruxism and clenching using the T-scan apparatus and magnetic resonance imaging. The study involved functional analysis using a digital T-scan device and magnetic resonance imaging. The results of the study, in patients with parafunctions, the average areas of wear facets were identified for each degree of severity for each side of the dentition. The values of occlusal parameters of the left side in patients in the group with bruxism and clenching prevail over the values of the right side of the dentition. With mild severity, there was a normal position of the articular disc and a small ventral displacement with reposition according to the Wilkes classification of internal disorders of the temporomandibular joint. With moderate severity, a small ventral displacement with and without reposition was noted. In severe cases, there was a small ventral displacement without reposition, a complete ventral displacement of the articular disc with and without reposition. Thus, it has been proven that diagnostics using digital analysis, assessing the severity of parafunctional activity and magnetic resonance data selects the necessary tactics for the treatment and prevention of dysfunctional conditions of the dental system. This technique allows for screening and monitoring of patients with bruxism and clenching.