In terms of temporomandibular joint dysfunction, according to Helkimo dysfunction index, comparison of bone changes determined in cone-beam computed tomography in symptomatic and asymptomatic patients and the relationship of this clinical index with bone changes on radiography

Abstract

Temporomandibular eklem disfonksiyonu açısından Helkimo disfonksiyon indeksine göre semptomatik ve asemptomatik hastalardaki, konik-ışınlı bilgisayarlı tomografide belirlenen kemik değişikliklerinin karşılaştırılması ve bu klinik indeksin radyografideki kemik değişiklikleriyle ilişkisi

Abstract

Amaç: Temporomandibular eklem disfonksiyonu (TMED); TME ve ilişkili olduğu kas, yumuşak doku ve kemik bileşenlerini etkileyen, bir şemsiye terimdir. Bu çalışmada, TMED açısından semptomatik ve asemptomatik hastaların, TME bölgesindeki kemik değişikliklerini karşılaştırmak, ayrıca Helkimo Di’nin (disfonksiyon indeksi) kemik değişiklikleri ve yaşla ilişkisinin araştırılması amaçlandı. Gereç ve yöntem: Çalışmaya, TMED açısından 34'ü semptomatik ve 34'ü asemptomatik toplam 68 hasta dahil edildi. TMED şiddetini belirlemek amacıyla yapılan klinik muayene kapsamında Helkimo Di kullanıldı. Radyolojik muayenede, konik-ışınlı bilgisayarlı tomografi (KIBT) ile TME bölgesindeki kemik değişiklikleri belirlendi. Bulgular: Çalışma grubunun yaş ortalaması 30,35'di ve %76,5’ı kadındı. Kontrol grubu için bu değerler 38,5 ve %44,1 idi (p<0,05). Glenoid fossada dejenerasyon dışında tüm kemik değişiklikleri çalışma grubunda daha fazla gözlendi. Ancak sadece, kondilde düzleşme, skleroz, osteofit ve artiküler eminenste düzleşme açısından istatistiksel olarak anlamlı fark vardı (p<0,05). Helkimo Di’nin şiddeti arttıkça, ortalama yaş ve TME bölgesindeki kemik değişikliği de artmaktaydı, ancak istatiksel olarak anlamlı fark yoktu (p>0,05). Sonuç: TMED hastalarında, TME bölgesindeki kemik değişiklerinin daha fazla gözlendiğini ancak bunun hastalığın şiddeti ile ilişkili olmadığını, bundan dolayı teşhis ve tedavi planlaması yaparken radyolojik bulguların yanında klinik muayenenin de önemli olduğu söylenebilir.

Keywords

• Temporomandibular eklem disfonksiyonu
• osteoartrit
• konik-ışınlı bilgisayarlı tomografi

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