hrvatski

Temporomandibularna disfunkcija u pacijentice s anksioznošću

A patient (28 yrs. old) during last year has noticed wear facets on the teeth and also the symptoms of temporomandibular disorders (TMD) - pain, limitation of mandibular movements, and before also clicking in right temporomadnibular joint (TMJ). The pain was evaluated with analog-visual scale (0– 10)=7. A case history revealed a presence of mental trauma for years ago, which caused the increase of anxiety and occurrence of panic attacks. By means of manual functional analysis the myofacial pain and anterior disc displacement without reduction in right TMJ was determined and confirmed with electronic axiography and magnetic resonance imaging (MRI). As a consequence of excessive teeth wear the interfering contacts in laterotrusive movements of mandibule were established. Anxiety was confirmed with psychological measuring instrument State-Trait Anxiety Inventory. For the initial treatment the fabriaction of Michigan splint was indicated. After 2 months the improvement in clinical condition was achieved. Stronger pain was only during larger mouth opening. In the right TMJ crepitation was found. In last few months she took irregularly prescribed anxiolytic drugs. She still feels anxious, tense and insecure. After 9 months the anterior disc dislocation without reduction and with present signs of subchondral degeneration and condylar aplation in right TMJ was established with controlling MRI. The orthopedic stability of TMJs was established with definitive occlusal treatment (restoration of wear teeth tissues with composite fillings). Because of accompaning osteoarthritis and better stabilisation of TMJs as well as teeth protection from bruxism the stabilisation splint was fabricated. Bruxism is pathophysiological disorder of unclear aethiology. The most noticeable sign of bruxism is excessive teeth wear which can cause pathological occlusal relationships. The mechanism of aethiopathogenesis of TMD is insufficiently explained and occlusion is considered to be secondary aethiological factor. Anxiety can be pathophysiological factor of bruxism and can lead to persistence of chronic temporomandibular pain.

TMD; anksioznost

nije evidentirano

engleski

Temporomandibular Disorders In Patient With Anxiety

A patient (28 yrs. old) during last year has noticed wear facets on the teeth and also the symptoms of temporomandibular disorders (TMD) - pain, limitation of mandibular movements, and before also clicking in right temporomadnibular joint (TMJ). The pain was evaluated with analog-visual scale (0– 10)=7. A case history revealed a presence of mental trauma for years ago, which caused the increase of anxiety and occurrence of panic attacks. By means of manual functional analysis the myofacial pain and anterior disc displacement without reduction in right TMJ was determined and confirmed with electronic axiography and magnetic resonance imaging (MRI). As a consequence of excessive teeth wear the interfering contacts in laterotrusive movements of mandibule were established. Anxiety was confirmed with psychological measuring instrument State-Trait Anxiety Inventory. For the initial treatment the fabriaction of Michigan splint was indicated. After 2 months the improvement in clinical condition was achieved. Stronger pain was only during larger mouth opening. In the right TMJ crepitation was found. In last few months she took irregularly prescribed anxiolytic drugs. She still feels anxious, tense and insecure. After 9 months the anterior disc dislocation without reduction and with present signs of subchondral degeneration and condylar aplation in right TMJ was established with controlling MRI. The orthopedic stability of TMJs was established with definitive occlusal treatment (restoration of wear teeth tissues with composite fillings). Because of accompaning osteoarthritis and better stabilisation of TMJs as well as teeth protection from bruxism the stabilisation splint was fabricated. Bruxism is pathophysiological disorder of unclear aethiology. The most noticeable sign of bruxism is excessive teeth wear which can cause pathological occlusal relationships. The mechanism of aethiopathogenesis of TMD is insufficiently explained and occlusion is considered to be secondary aethiological factor. Anxiety can be pathophysiological factor of bruxism and can lead to persistence of chronic temporomandibular pain.

TMD; anxiety

nije evidentirano