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Post a Comment A complex treatment of irreducible displacement of the temporomandibular joint disc and myofascial pain disorders with the use of botulinum toxin
- Authors: Ilyin A.A.1, Fazylova T.A.1, Demchinsky E.A.1, Olesova V.N.2, Olesov E.E.2
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Affiliations:
- Dental Сlinic «Implantium»
- Academy of Postgraduate Education under the FSBU «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency»
- Issue: Vol 10, No 2 (2019)
- Pages: 14-20
- Section: Original Study Articles
- URL: https://journals.rcsi.science/clinpractice/article/view/15181
- DOI: https://doi.org/10.17816/clinpract10214-20
- ID: 15181
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Abstract
Background. An irreducible displacement of the articular disc (IDD) is one of the TMJ conditions characterized by complexity of clinical manifestations, severity and is always accompanied by myofascial pain disorders.
Objective. To improve the results of treatment of patients with TMJ IDD and myofascial pain syndromes.
Methods. We performed a clinical examination and treatment of 38 patients with irreducible displacement of the TMJ articular disc and myofascial pain disorders. As additional research methods, we used CBCT, MRI, EMG. A step-by-step treatment was conducted, including a drug therapy, injection of botulinum toxin type A (BTA) in the masticatory, temporal, lateral pterygoid muscles (LPM) bilaterally; repositional splint therapy; arthrocentesis with the lavage of both articular spaces.
Results. The overall effectiveness of the treatment was 97.4%. Out of 38 patients, 34 (89.5%) were treated without arthrocentesis with the complete restoration of the mandibular movement volume and elimination of pain syndrome.
Conclusions. An effective system has been developed for a sequential complex treatment of TMJ IDD; a new technique has been developed for a periarticular injection access to the LPM allowing administration of a drug to its upper and lower heads. The high efficiency of BTA injections in the treatment of TMJ IDD is due to the mandatory drug administration into 3 muscles: masticatory, temporal and lateral pterygoid. In the treatment of TMJ IDD, arthrocentesis is effective with lavage of the lower and upper articular spaces.
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##article.viewOnOriginalSite##About the authors
Aleksander A. Ilyin
Dental Сlinic «Implantium»
Email: Alex2017ilyin@yandex.ru
ORCID iD: 0000-0002-8021-4599
SPIN-code: 2615-2137
д-р мед. наук, профессор, челюстно-лицевой хирург, стоматолог-хирург
Russian Federation, MoscowT. A. Fazylova
Dental Сlinic «Implantium»
Author for correspondence.
Email: tfazylova@yandex.ru
ORCID iD: 0000-0001-5878-6761
SPIN-code: 5248-5572
врач стоматолог-ортодонт
Russian Federation, MoscowE. A. Demchinsky
Dental Сlinic «Implantium»
Email: domhelen@bk.ru
ORCID iD: 0000-0002-8917-4706
SPIN-code: 6851-5618
канд. мед. наук, врач-стоматолог
Russian Federation, MoscowV. N. Olesova
Academy of Postgraduate Education under the FSBU «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency»
Email: olesova@implantat.ru
ORCID iD: 0000-0002-3461-9317
SPIN-code: 6851-5618
д-р мед. наук, профессор кафедры клинической стоматологии и имплантологии
Russian Federation, MoscowE. E. Olesov
Academy of Postgraduate Education under the FSBU «Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency»
Email: olesov_georgiy@mail.ru
ORCID iD: 0000-0001-9165-2554
SPIN-code: 8924-3520
д-р мед. наук, доцент, зав. кафедрой клинической стоматологии и имплантологии
Russian Federation, MoscowReferences
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