FEATURES OF THE FUNCTIONING OF THE MAXILLO-FACIAL REGION AND THE TEMPO-MANDIBULAR JOINT IN PATIENTS WITH BRUXISM AND THE POSSIBILITY OF THEIR CORRECTION BY PHYSICAL THERAPY

Abstract

Purpose is to evaluate the effectiveness of the developed physical therapy program on the functioning parameters of the orofacial zone and the temporomandibular joint as criteria for the effectiveness of the rehabilitation of individuals with bruxism. Material. The control group consisted of 32 people without burdened dental status. Group 1 consisted of 31 people with bruxism, which was corrected with individual relaxing splints. Group 2 consisted of 32 people with bruxism, in whom, in addition to splints, a physical therapy program was applied: therapeutic exercises, massage, postisometric relaxation, kinesiological taping for masticatory muscles, facial muscles, neck, cervical-collar zone, back, shoulder girdle, transcutaneous electromyostimulation of masticatory muscles; autorelaxation sessions according to Schultz; patient education. The effectiveness of the program was evaluated by the dynamics of complaints, results of dental and general examination, measurement of the amplitude of movements of the lower jaw, the “Hamburg test”, the Helkimo index. Results. In patients with bruxism, signs of dysfunction of the maxillofacial area and the temporomandibular joint were identified in the form of numerous complaints of pain and dysfunction of the orofacial area, chewing disorders, changes in the area of the masticatory muscles, the front and lateral surfaces of the neck and the cervical spine, which supported by the results of the examination, measurement of the amplitude of movements of the lower jaw, the protocol of the “Hamburg test”, the Helkimo index. The complex physical therapy program demonstrated a statistically significantly better effect (p<0.05) on the studied indicators compared to the initial data; a decrease in the number of complaints, an improvement in the amplitude of movements of the lower jaw, and a decrease in the severity of temporomandibular joint dysfunction were determined. In patients who received an effect only on the peripheral component of bruxism (individual relaxation splints), an improvement in the studied indicators was determined, which in terms of magnitude was inferior to the effectiveness of the developed program of active functional rehabilitation. Conclusions. In the rehabilitation of patients with bruxism, it is advisable to include measures taking into account and correcting not only local dental, but also general somatic consequences of bruxism, which will improve their quality of life.