Çocuklarda Temporomandibular Eklem Rahatsızlıkları: Klinik Özellikler, Tanı ve Tedavi Yaklaşımları

Yıl 2025, Cilt: 34 Sayı: 4, 262 - 273, 24.12.2025

Hatice Aydoğdu

https://doi.org/10.17827/aktd.1793263

Öz

Bu derleme, çocuk ve ergenlerde temporomandibular eklem bozukluklarının (TMB) epidemiyolojisini, etiyolojik faktörlerini, klinik bulgularını, tanı süreçlerini ve tedavi yaklaşımlarını güncel literatür ışığında kapsamlı biçimde değerlendirmeyi amaçlamaktadır. Çocukluk döneminde TMB’nin sıklığı kullanılan tanı kriterlerine göre değişmekle birlikte geniş bir aralıkta bildirilmektedir ve özellikle ergenlik dönemine geçişle kız çocuklarında belirgin bir artış göstermektedir. TMB’nin etiyolojisi multifaktöriyel olup parafonksiyonel alışkanlıklar, travma, maloklüzyonlar, büyüme-gelişim süreçleri, hormonal değişiklikler, sistemik hastalıklar ve psikososyal stres gibi çeşitli faktörlerin etkileşimi sonucunda ortaya çıkmaktadır. Klinik olarak ağrı, eklem sesleri, çene hareketlerinde kısıtlılık, kas hassasiyeti ve baş-boyun bölgesine yayılan yakınmalar en sık gözlenen belirtilerdir. Tanı; ayrıntılı anamnez, palpasyon, mandibular hareketlerin değerlendirilmesi ve gerektiğinde görüntüleme yöntemleri (BT, MRG, ultrasonografi) ile desteklenmektedir. Tedavide öncelik konservatif ve geri dönüşümlü yöntemlerde olup hasta eğitimi, davranışsal terapi, parafonksiyonların azaltılması, evde bakım önerileri, fizik tedavi uygulamaları ve kısa süreli farmakolojik destek temel yaklaşımlar arasındadır. Oklüzal apareyler, özellikle parafonksiyon ve artralji yönetiminde kullanılmakla birlikte, büyüme-gelişim dönemindeki çocuklarda dikkatle planlanmalıdır. Cerrahi müdahaleler ise yalnızca konservatif yöntemlere yanıt vermeyen ve yapısal bozukluğun belirgin olduğu seçilmiş vakalarda düşünülmelidir. Bu derleme, pediatrik TMB yönetiminde erken tanının, multidisipliner yaklaşımın ve bireyselleştirilmiş tedavi planlarının önemini vurgulamakta; mevcut kanıtların sınırlı olması nedeniyle daha güçlü metodolojik çalışmaların gerekliliğini ortaya koymaktadır.

Anahtar Kelimeler

temporomandibular eklem bozuklukları , çocuk diş hekimliği , Multidisipliner yaklaşım

Etik Beyan

Bu çalışma, literatür taraması şeklinde hazırlanmış olup, herhangi bir insan veya hayvan deneyi içermemektedir. Çalışma, bilimsel araştırma ve yayın etiği kurallarına uygun olarak hazırlanmıştır.

Destekleyen Kurum

yoktur

Teşekkür

yoktur

Temporomandibular Disorders in Children: Clinical Features, Diagnosis, and Treatment Approaches

Öz

This review aims to comprehensively evaluate the epidemiology, etiological factors, clinical manifestations, diagnostic approaches, and treatment strategies of temporomandibular disorders (TMD) in children and adolescents in light of current literature. The prevalence of pediatric TMD varies widely depending on diagnostic criteria and assessment methods, and a marked increase is observed during adolescence, particularly among females. The etiology of TMD is multifactorial, arising from the interaction of parafunctional habits, trauma, malocclusions, developmental and hormonal changes, systemic diseases, and psychosocial stressors. Clinically, TMD presents with pain, joint sounds, limitations in mandibular movements, masticatory muscle tenderness, and symptoms radiating to the head and neck region. Diagnosis is based on a detailed history, clinical examination, functional assessment of the mandible, and, when necessary, imaging methods such as CT, MRI, or ultrasonography. Treatment primarily focuses on conservative and reversible approaches, including patient education, behavioral interventions, elimination of parafunctional habits, home-care instructions, physical therapy modalities, and short-term pharmacotherapy. Occlusal appliances may be indicated particularly for parafunctional behaviors and arthralgia; however, their use should be carefully planned in growing patients. Surgical interventions are reserved for select cases in which structural pathology is evident and conservative methods fail. This review emphasizes the importance of early diagnosis, multidisciplinary management, and individualized treatment planning in pediatric TMD. Furthermore, the limited number of high-quality studies in the pediatric population highlights the need for future research with stronger methodological designs to establish evidence-based clinical protocols.

Anahtar Kelimeler

Temporomandibular disorders , Pediatric dentistry , Multidisciplinary approach

Etik Beyan

This study was prepared as a literature review and does not involve any human or animal experiments. The study has been conducted in accordance with the principles of scientific research and publication ethics.

Destekleyen Kurum

none

Teşekkür

none

Kaynakça

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