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Temporomandibular Eklem Bozukluklarında Güncel Tedavi Yaklaşımları

Year 2022, Volume: 11 Issue: 3, 318 - 331, 19.09.2022
https://doi.org/10.54617/adoklinikbilimler.1084165

Abstract

Temporomandibular eklem bozuklukları; çiğneme kaslarının, temporomandibular eklem ve temporomandibular ekleme komşu dokuların çoğunlukla ağrılı, fizyolojik ve fonksiyonel bozuklukları olarak tanımlanmaktadır. Günümüzde diş hekimliğinde hala önemli bir sorun olan temporomandibular eklem bozukluklarına iyatrojenik faktörler, okluzyon bozukluğu, travma, emosyonel değişimler gibi birçok faktör sebep olabilmektedir. Tedavisinde etken olan etiyolojik ve patolojik faktörlerin düzeltilmesi, hastalık semptomlarının giderilmesi, eklem mobilitesinin yeniden sağlanması ve postural iyileşme amaçlanmaktadır. Bu amaçla tedavide hasta eğitimleri, farmakolojik ajanların kullanımı, psikolojik tedavi uygulamaları, fiziksel tedavi, manuel tedavi, okluzal splintlerin kullanımı ve cerrahi tedavi yaklaşımları tek tek veya kombine halde uygulanabilmektedir.

References

  • 1. Pedroni CR, De Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J Oral Rehabil 2003;30:283-9.
  • 2. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. St. Louis, Missouri:Elsevier Mosby; 2020.p. 102-371
  • 3. Yener M, Aynali G. Temporomandibular eklem bozukluklarında tedavi seçenekleri. SDÜ Sağlık Bilimleri Enstütüsü Dergisi 2012;3:150-5.
  • 4. Yaltırık M, Palancıoğlu A, Turgut CT, Koray M. Temporomandibular bozuklukların tedavileri. Yeditepe J Dent 2017;14:71-80.
  • 5. Kavuncu V. Temporomandibular Eklem Disfonksiyon Sendromu. Göksoy T, editor. Romatizmal Hastalıkların Tanı ve Tedavisi. İstanbul: Yüce Basımevi; 2002. p. 791-802.
  • 6. Wu M, Cai J, Yu Y, Hu S, Wang Y, Wu M. Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective. Front Pharmacol 2020;11:1-17.
  • 7. Hersh EV, Balasubramaniam R, Pinto A. Pharmacologic management of temporomandibular disorders. Oral Maxillofac Surg Clin North Am 2008;20:197-210.
  • 8. Andre A, Kang J, Dym H. Pharmacologic Treatment for Temporomandibular and Temporomandibular Joint Disorders. Oral Maxillofac Surg Clin North Am 2022;34:49-59.
  • 9. Ouanounou A, Goldberg M, Haas DA. Pharmacotherapy in Temporomandibular Disorders: A Review. J Can Dent Assoc 2017;83:1-8.
  • 10. Bal Küçük B, Tolunay Kaya S, Karagöz Motro P, Oral K. Pharmacotherapeutic Agents Used in Temporomandibular Disorders. Oral Diseases 2014;20:740-3.
  • 11. Grennan D, Wang S. Steroid Side Effects. JAMA 2019;322:282.
  • 12. Wright EF. Manuel of temporomandibular disorders. 2nd ed. Ames, LA: Wiley-Blackwell; 2010. p.251- 61
  • 13. Lobo SL, Mehta N, Forgione AG, Melis M, Al-Badawi E, Ceneviz C, et al. Use of Theraflex-TMJ topical cream for the treatment of temporomandibular joint and muscle pain. Cranio 2004;22:137-44.
  • 14. Wright EF. Cognitive-Behavioral Intervention. 2nd ed. Wright E.F, editor Manual of temporomandibular disorders. Ames,LA: Wiley-Blackwell; 2010. p. 239- 49
  • 15. Çapan N. Temporomandibuiar Eklem Rahatsizliklarinda Fizik Tedavi Yöntemleri, Egzersizier ve Postoperatif Rehabiiitasyon. Turk J Phys Rehab 2010;56:15-8.
  • 16. Saranya B, Ahmed J, Shenoy N, Ongole R, Sujir N, Natarajan S. Comparison of Transcutaneous Electric Nerve Stimulation (TENS) and Microcurrent Nerve Stimulation (MENS) in the Management of Masticatory Muscle Pain: A Comparative Study. Pain Res Manag 2019;2019:1-5.
  • 17. Rodrigues D, Siriani AO, Berzin F. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients. Braz Oral Res 2004;18:290-5.
  • 18. Monaco A, Sgolastra F, Pietropaoli D, Giannoni M, Cattaneo R. Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: a controlled clinical trial. BMC Musculoskelet Disord 2013;14:168.
  • 19. Zayan K, Felix ER, Galor A. Transcutaneous Electrical Nerve Stimulation for Facial Pain. Prog Neurol Surg 2020;35:35-44.
  • 20. Loeser JD. Bonica’s management of pain. 3nd ed. USA: Lippincot Williams; 2001. p. 887- 902
  • 21. Kwekkeboom KL, Gretarsdottir E. Systematic review of relaxation interventions for pain. J Nurs Scholarsh 2006;38:269-77.
  • 22. Beyazova M, Kutsal YG. Fiziksel tıp ve rehabilitasyon. Ankara: Güneş Kitapevi; 2000. p.9-70
  • 23. Van der Windt D, Van der Heijden G, Van den Berg S.G.M, Ter Riet G, de Winter A.F, Bouter LM. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain 1999;81:257-71.
  • 24. Ramakrishnan SN, Aswath N. Comparative efficacy of analgesic gel phonophoresis and ultrasound in the treatment of temporomandibular joint disorders. Indian J Dent Res 2019;30:512-5.
  • 25. Shin SM, Choi JK. Effect of indomethacin phonophoresis on the relief of temporomandibular joint pain. Cranio 1997;15:345-8.
  • 26. Lark MR, Gangarosa LP. Iontophoresis: an effective modality for the treatment of inflammatory disorders of the temporomandibular joint and myofascial pain. Cranio 1990;8:108-19.
  • 27. Madani A, Ahrari F, Fallahrastegar A, Daghestani N. A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci 2020;35:181-92.
  • 28. Raustia AM, Pohjola RT. Acupuncture compared with stomatognathic treatment for TMJ dysfunction. Part III: Effect of treatment on mobility. J Prosthet Dent 1986;56:616-23.
  • 29. Vicente-Barrero M, Yu-Lu SL, Zhang B, Bocanegra-Perez S, Duran-Moreno D, Lopez-Marquez A, et al. The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome. Med Oral Patol Oral Cir Bucal 2012;17:1028-33.
  • 30. List T, Helkimo M, Karlsson R. Pressure pain thresholds in patients with craniomandibular disorders before and after treatment with acupuncture and occlusal splint therapy: a controlled clinical study. J Orofac Pain 1993;7:275-82.
  • 31. Chen J, Huang Z, Ge M, Gao M. Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 2015;42:291-9.
  • 32. Munguia FM, Jang J, Salem M, Clark GT, Enciso R. Efficacy of Low-Level Laser Therapy in the Treatment of Temporomandibular Myofascial Pain: A Systematic Review and Meta-Analysis. J Oral Facial Pain Headache 2018;32:287-97.
  • 33. Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 2006;24:158-68.
  • 34. Xu GZ, Jia J, Jin L, Li JH, Wang ZY, Cao DY. Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis. Pain Res Manag 2018;2018:1-13.
  • 35. Brochado FT, Jesus LH, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018;32:50-62.
  • 36. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther 2016;96:9-25.
  • 37. Donnelly JM. Travell, Simons & Simons’ Myofascial Pain and Dysfunction. 3th ed. Philadelphia: Wolters Kluwer; 2019 p. 298-444
  • 38. Tekel N, Kahraman S. Temporomandibular Bozuklukların Tedavisinde Okluzal Splintlerin Kullanımı. Atatürk Üniv Diş Hek Fak Derg 2006:61-69.
  • 39. Bjornland T, Gjaerum AA, Moystad A. Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate. J Oral Rehabil 2007;34:583-9.
  • 40. Walker K, Basehore BM, Goyal A, Bansal P, Zito PM. Hyaluronic Acid. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
  • 41. Dionne RA. Pharmacologic approaches. Laskin DM, Greene CS, Hylander WL, editors. TMD's An Evidance-Based Approach to Diagnosis and Treatment. Hanover Park, IL: Quintessence; 2006. p. 347-57
  • 42. Dıraçoğlu D. Temporomondibular Eklem Bölgesinde Enjeksiyon Tedavileri. Türk Fiz Tıp Rehab Derg 2010;56:1-6.
  • 43. Al-Belasy FA, Dolwick MF. Arthrocentesis for the treatment of temporomandibular joint closed lock: a review article. Int J Oral Maxillofac Surg 2007;36:773-82.
  • 44. Şentürk MF. Temporomandibuler eklem artrosentez teknikleri: Literatür derlemesi. SDÜ Sağlık Bilimleri Enstütüsi Derg 2014;5:114-7.
  • 45. Zoltán Gábor Raskó M. Clinical Application of Cone-Beam Computed Tomography for Evaluation of Peri-Implant Bone Thickness and Temporomandibular Joint Imaging tez. Szeged:University of Szeged; 2019.
  • 46. Durmuşlar MC. Temporomandibular Eklem Artroskopisi. ADO Klinik Bilimler Dergisi 2012;6:1187-91.
  • 47. Keklik B, Yazar M, Emekli U. Artrosentez, Artroskopik Değerlendirme ve Cerrahi Girişimler. Türk Fiz Tıp Rehab Derg 2010;56:29-33.
  • 48. Miloro M, Ghali GE, Larsen PE, Waite PD. Peterson’s Principles of Oral and Maxillofacial Surgery. 3nd ed. Shelton,CT: People’s Medical Publishing House-USA; 2011. p. 1151-60
  • 49. Okçu UM. TME Ankiloz Çeşitleri ve Tedavileri tez. İstanbul: İstanbul Üniversitesi; 2020.
  • 50. Nale JC. Orthognathic surgery and the temporomandibular joint patient. Oral Maxillofac Surg Clin North Am 2014;26:551-64.
Year 2022, Volume: 11 Issue: 3, 318 - 331, 19.09.2022
https://doi.org/10.54617/adoklinikbilimler.1084165

Abstract

References

  • 1. Pedroni CR, De Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J Oral Rehabil 2003;30:283-9.
  • 2. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th ed. St. Louis, Missouri:Elsevier Mosby; 2020.p. 102-371
  • 3. Yener M, Aynali G. Temporomandibular eklem bozukluklarında tedavi seçenekleri. SDÜ Sağlık Bilimleri Enstütüsü Dergisi 2012;3:150-5.
  • 4. Yaltırık M, Palancıoğlu A, Turgut CT, Koray M. Temporomandibular bozuklukların tedavileri. Yeditepe J Dent 2017;14:71-80.
  • 5. Kavuncu V. Temporomandibular Eklem Disfonksiyon Sendromu. Göksoy T, editor. Romatizmal Hastalıkların Tanı ve Tedavisi. İstanbul: Yüce Basımevi; 2002. p. 791-802.
  • 6. Wu M, Cai J, Yu Y, Hu S, Wang Y, Wu M. Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective. Front Pharmacol 2020;11:1-17.
  • 7. Hersh EV, Balasubramaniam R, Pinto A. Pharmacologic management of temporomandibular disorders. Oral Maxillofac Surg Clin North Am 2008;20:197-210.
  • 8. Andre A, Kang J, Dym H. Pharmacologic Treatment for Temporomandibular and Temporomandibular Joint Disorders. Oral Maxillofac Surg Clin North Am 2022;34:49-59.
  • 9. Ouanounou A, Goldberg M, Haas DA. Pharmacotherapy in Temporomandibular Disorders: A Review. J Can Dent Assoc 2017;83:1-8.
  • 10. Bal Küçük B, Tolunay Kaya S, Karagöz Motro P, Oral K. Pharmacotherapeutic Agents Used in Temporomandibular Disorders. Oral Diseases 2014;20:740-3.
  • 11. Grennan D, Wang S. Steroid Side Effects. JAMA 2019;322:282.
  • 12. Wright EF. Manuel of temporomandibular disorders. 2nd ed. Ames, LA: Wiley-Blackwell; 2010. p.251- 61
  • 13. Lobo SL, Mehta N, Forgione AG, Melis M, Al-Badawi E, Ceneviz C, et al. Use of Theraflex-TMJ topical cream for the treatment of temporomandibular joint and muscle pain. Cranio 2004;22:137-44.
  • 14. Wright EF. Cognitive-Behavioral Intervention. 2nd ed. Wright E.F, editor Manual of temporomandibular disorders. Ames,LA: Wiley-Blackwell; 2010. p. 239- 49
  • 15. Çapan N. Temporomandibuiar Eklem Rahatsizliklarinda Fizik Tedavi Yöntemleri, Egzersizier ve Postoperatif Rehabiiitasyon. Turk J Phys Rehab 2010;56:15-8.
  • 16. Saranya B, Ahmed J, Shenoy N, Ongole R, Sujir N, Natarajan S. Comparison of Transcutaneous Electric Nerve Stimulation (TENS) and Microcurrent Nerve Stimulation (MENS) in the Management of Masticatory Muscle Pain: A Comparative Study. Pain Res Manag 2019;2019:1-5.
  • 17. Rodrigues D, Siriani AO, Berzin F. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients. Braz Oral Res 2004;18:290-5.
  • 18. Monaco A, Sgolastra F, Pietropaoli D, Giannoni M, Cattaneo R. Comparison between sensory and motor transcutaneous electrical nervous stimulation on electromyographic and kinesiographic activity of patients with temporomandibular disorder: a controlled clinical trial. BMC Musculoskelet Disord 2013;14:168.
  • 19. Zayan K, Felix ER, Galor A. Transcutaneous Electrical Nerve Stimulation for Facial Pain. Prog Neurol Surg 2020;35:35-44.
  • 20. Loeser JD. Bonica’s management of pain. 3nd ed. USA: Lippincot Williams; 2001. p. 887- 902
  • 21. Kwekkeboom KL, Gretarsdottir E. Systematic review of relaxation interventions for pain. J Nurs Scholarsh 2006;38:269-77.
  • 22. Beyazova M, Kutsal YG. Fiziksel tıp ve rehabilitasyon. Ankara: Güneş Kitapevi; 2000. p.9-70
  • 23. Van der Windt D, Van der Heijden G, Van den Berg S.G.M, Ter Riet G, de Winter A.F, Bouter LM. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain 1999;81:257-71.
  • 24. Ramakrishnan SN, Aswath N. Comparative efficacy of analgesic gel phonophoresis and ultrasound in the treatment of temporomandibular joint disorders. Indian J Dent Res 2019;30:512-5.
  • 25. Shin SM, Choi JK. Effect of indomethacin phonophoresis on the relief of temporomandibular joint pain. Cranio 1997;15:345-8.
  • 26. Lark MR, Gangarosa LP. Iontophoresis: an effective modality for the treatment of inflammatory disorders of the temporomandibular joint and myofascial pain. Cranio 1990;8:108-19.
  • 27. Madani A, Ahrari F, Fallahrastegar A, Daghestani N. A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders. Lasers Med Sci 2020;35:181-92.
  • 28. Raustia AM, Pohjola RT. Acupuncture compared with stomatognathic treatment for TMJ dysfunction. Part III: Effect of treatment on mobility. J Prosthet Dent 1986;56:616-23.
  • 29. Vicente-Barrero M, Yu-Lu SL, Zhang B, Bocanegra-Perez S, Duran-Moreno D, Lopez-Marquez A, et al. The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome. Med Oral Patol Oral Cir Bucal 2012;17:1028-33.
  • 30. List T, Helkimo M, Karlsson R. Pressure pain thresholds in patients with craniomandibular disorders before and after treatment with acupuncture and occlusal splint therapy: a controlled clinical study. J Orofac Pain 1993;7:275-82.
  • 31. Chen J, Huang Z, Ge M, Gao M. Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 2015;42:291-9.
  • 32. Munguia FM, Jang J, Salem M, Clark GT, Enciso R. Efficacy of Low-Level Laser Therapy in the Treatment of Temporomandibular Myofascial Pain: A Systematic Review and Meta-Analysis. J Oral Facial Pain Headache 2018;32:287-97.
  • 33. Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RA. Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 2006;24:158-68.
  • 34. Xu GZ, Jia J, Jin L, Li JH, Wang ZY, Cao DY. Low-Level Laser Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis. Pain Res Manag 2018;2018:1-13.
  • 35. Brochado FT, Jesus LH, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018;32:50-62.
  • 36. Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther 2016;96:9-25.
  • 37. Donnelly JM. Travell, Simons & Simons’ Myofascial Pain and Dysfunction. 3th ed. Philadelphia: Wolters Kluwer; 2019 p. 298-444
  • 38. Tekel N, Kahraman S. Temporomandibular Bozuklukların Tedavisinde Okluzal Splintlerin Kullanımı. Atatürk Üniv Diş Hek Fak Derg 2006:61-69.
  • 39. Bjornland T, Gjaerum AA, Moystad A. Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate. J Oral Rehabil 2007;34:583-9.
  • 40. Walker K, Basehore BM, Goyal A, Bansal P, Zito PM. Hyaluronic Acid. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
  • 41. Dionne RA. Pharmacologic approaches. Laskin DM, Greene CS, Hylander WL, editors. TMD's An Evidance-Based Approach to Diagnosis and Treatment. Hanover Park, IL: Quintessence; 2006. p. 347-57
  • 42. Dıraçoğlu D. Temporomondibular Eklem Bölgesinde Enjeksiyon Tedavileri. Türk Fiz Tıp Rehab Derg 2010;56:1-6.
  • 43. Al-Belasy FA, Dolwick MF. Arthrocentesis for the treatment of temporomandibular joint closed lock: a review article. Int J Oral Maxillofac Surg 2007;36:773-82.
  • 44. Şentürk MF. Temporomandibuler eklem artrosentez teknikleri: Literatür derlemesi. SDÜ Sağlık Bilimleri Enstütüsi Derg 2014;5:114-7.
  • 45. Zoltán Gábor Raskó M. Clinical Application of Cone-Beam Computed Tomography for Evaluation of Peri-Implant Bone Thickness and Temporomandibular Joint Imaging tez. Szeged:University of Szeged; 2019.
  • 46. Durmuşlar MC. Temporomandibular Eklem Artroskopisi. ADO Klinik Bilimler Dergisi 2012;6:1187-91.
  • 47. Keklik B, Yazar M, Emekli U. Artrosentez, Artroskopik Değerlendirme ve Cerrahi Girişimler. Türk Fiz Tıp Rehab Derg 2010;56:29-33.
  • 48. Miloro M, Ghali GE, Larsen PE, Waite PD. Peterson’s Principles of Oral and Maxillofacial Surgery. 3nd ed. Shelton,CT: People’s Medical Publishing House-USA; 2011. p. 1151-60
  • 49. Okçu UM. TME Ankiloz Çeşitleri ve Tedavileri tez. İstanbul: İstanbul Üniversitesi; 2020.
  • 50. Nale JC. Orthognathic surgery and the temporomandibular joint patient. Oral Maxillofac Surg Clin North Am 2014;26:551-64.
There are 50 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Derleme
Authors

Özgecan Yüceler 0000-0003-3776-8972

Öykü Öztürk 0000-0002-9970-1506

Dilek Aynur Uğar Çankal 0000-0003-0043-9315

Publication Date September 19, 2022
Submission Date March 7, 2022
Published in Issue Year 2022 Volume: 11 Issue: 3

Cite

Vancouver Yüceler Ö, Öztürk Ö, Uğar Çankal DA. Temporomandibular Eklem Bozukluklarında Güncel Tedavi Yaklaşımları. ADO Klinik Bilimler Dergisi. 2022;11(3):318-31.