ASSESSMENT AND RECTIFICATION OF TEMPOROMANDIBULAR JOINT ALTERATIONS IN PATIENTS WITH DENTAL DEFICIENCIES COMPLICATED BY DISTAL MANDIBULAR DISPLACEMENT
Abstract
Resume. This research assesses the morphological and functional changes of the temporomandibular joint (TMJ) in individuals with partial dentition abnormalities accompanied by distal mandibular displacement. The study used lateral tomography (ORTHOPHOS 3) and magnetic resonance imaging (MRI) to reveal notable topographical alterations, such as a decrease in articular tubercle height and an increase in joint space asymmetry (up to 50%). Clinically, these alterations presented as articulatory crepitus, myofascial discomfort, and limited movement. A two-phase treatment regimen was executed to address these modifications. The first phase included orthodontic realignment via a specific hinged device aimed at stabilizing the mandible in the sagittal plane while allowing for transverse mobility, augmented by myotherapy and physical rehabilitation. The second stage concentrated on enduring orthopedic rehabilitation using casts and ceramic prosthetic devices. The results demonstrated a 45% enhancement in the advantageous anterior location of the articular head and a 40% augmentation in bilateral symmetry after the first stage. The research suggests that prosthetic rehabilitation should follow orthodontic normalization of the occlusal-articulation connection to guarantee the long-term stability of the TMJ complex. Keywords: Temporomandibular joint (TMJ), distal mandibular displacement, dental anomalies, orthodontic realignment, orthopedic therapy, joint dysfunction.