RESUMO
Data collected on 224 patients of both sexes aged between 9 and 72 and suffering from temporomandibular dysfunctional algias have been examined. The observed prevalence of the female sex and young adults is in agreement with other researches. The most frequent, variously imbricated pathologies were the meniscal (62%), musculoligamentous (53%) and inflammatory and degenerative (21%). Having confirmed the multifactorial aetiology, and individual treatment plan was worked out. Of the initial therapies, active gymnastics, repositioning and stabilisation occlusion measures, relaxation practices, bland aspecific drugs were of particular importance. The final therapy contemplated above all prostheses and orthodontia as structural measures with a deliberate choice of conservative approach.
Assuntos
Síndrome da Disfunção da Articulação Temporomandibular/diagnóstico , Adolescente , Adulto , Idoso , Auscultação , Criança , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Radiografia , Articulação Temporomandibular/diagnóstico por imagem , Síndrome da Disfunção da Articulação Temporomandibular/terapiaRESUMO
A clinical and epidemiological investigation was performed on a sample of randomly selected rheumatic patients in order to identify the prevalence of signs and symptoms of mandibular dysfunction. The collected data were used to calculate the Helkimo Anamnestic and Clinical Dysfunction Index. Signs of dysfunction were found in all the subjects (except one) and were significantly commoner in women than in men (p less than 0.01). The commonest clinical findings were: sound from the TMJ (crepitus or grating noise), impaired mandibular mobility, tenderness to palpation of the masticatory muscles. The comparison with a sample of a non-selected control-group was statistically significant (p less than 0.001). Contemporary radiographic examination demonstrated in many cases extreme resorbtion and remodelling of the condyle, increase of joint space and erosion of the fossa, otherwise reduced joint space and sclerosis, depending on superimposed degenerative arthritis (usually more painful). The survey showed a significant incidence of structural as well as functional involvement of TMJ in RA and suggested a more careful diagnostic and therapeutic approach.
Assuntos
Artrite Reumatoide/complicações , Transtornos da Articulação Temporomandibular/complicações , Adulto , Idoso , Artrite Reumatoide/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Transtornos da Articulação Temporomandibular/epidemiologiaRESUMO
A clinical investigation was performed on a sample of 91 randomly selected rheumatic (R.A.) patients, 70 females and 21 males (mean age 52.6), and in a control group of 41 not R. A. subjects, in order to identify the prevalence of signs and symptoms of temporo-mandibular joint (t.m.j.) dysfunction. The collected data were used to calculate the Helkimo Anamnestic and Clinical Indices. Signs of dysfunction were found in almost all the subjects (except three) and their frequency was significantly higher in women than in men (p less than 0.01). The most common clinical findings were: crepitus from t.m.j. (not significant), impaired mandibular mobility (p less than 0.001), tenderness to palpation of the masticatory muscles, and macroglossia (p less than 0.01). Radiographic examination was also performed in 51 patients, showing in many cases signs of inflammatory arthritis as well as of overimposed degenerative arthritis. The survey showed a significant incidence of structural and functional involvement of t.m.j. in R.A.