hrvatski

Osteoartiritis čeljusnog zgloba i protetska terapija – prikaz slučaja

U radu je opisana složena protetska rehabilitacija 45-godišnjeg pacijenta pomoću okluzijske udlage, kojem je kao sredstvom inicijalne terapije provedeno neuromuskularno reproramiranje, repozicija kondila unutar zglobne jamice kao i okluzijska stabilnost i adaptacija na novu okluzijsku vertikalnu dimenziju. Pacijent je imao simptome u temporomandibualrnim zglobovima, jače u lijevom zglobu. Povezao je prisutne simptome s opsežnim restauracijskim zahvatima. Primjetio je da mu se smanjuje vertikalni prijeklop prednjih zubi nakon restauracijskih zahvata, što je uzrokovano trošenjem zubi. Na prikazu magnetske rezonancije lijevog temporomandibularnog zgloba prikazane su degenerativne promjene sa subhondralnom sklerozacijom u području zglobne kvržice i anterioni pomak zglobne pločice. Nakon uspješne inicijalne terapije okuzijskom udlagom omogućena je definitivna protetska terapija. Nakon tri godine na snimkama magnetske rezonancije prikazan je nepromjenjeni status temporomandibularnih zglobova, iako pacijent nije imao recidiv simptoma temporomandibularnog poremećaja. Niti remodelacijske promjene na kondilu nisu utjecaje na eventualno pogoršanje funkcijskog stanja. This case report describes the complex prosthodontic rehabilitation of a 45 year-old male patient by using an occlusal splint as a means of initial treatment for neuromuscular reprogramming, for repositioning of the condyle within the mandibular fossa to obtain occlusal stability and thus allowing adaptation to a new occlusal vertical dimension (OVD). The patient had experienced temporomandibular joint (TMJ) symptoms, which were more pronounced in the left TMJ. He connected the occurrence of symptoms with extensive prosthetic restoration. He had noticed lowering of the vertical overlap of the front teeth after restorative treatments, which was exacerbated by tooth wear. The appearance of the left TMJ by means of magnetic resonance imaging (MRI) showed degenerative changes with subchondral sclerosation in the area of the articular eminence, and anterior disc displacement. Definitive prosthodontic treatment was made possible by the successful initial treatment with the splint. Three years later the MRI showed unchanged status of TMJ although the patient did not have recurring TMD symptoms. Even the remodeling alterations on the condyle did not affect the possible deterioration of the functional condition.

osteoartritis; čeljusni zglob; protetska terapija

nije evidentirano

engleski

Osteoarthritis of temporomandibular joint and prosthetic dentistry - a reported case

U radu je opisana složena protetska rehabilitacija 45-godišnjeg pacijenta pomoću okluzijske udlage, kojem je kao sredstvom inicijalne terapije provedeno neuromuskularno reproramiranje, repozicija kondila unutar zglobne jamice kao i okluzijska stabilnost i adaptacija na novu okluzijsku vertikalnu dimenziju. Pacijent je imao simptome u temporomandibualrnim zglobovima, jače u lijevom zglobu. Povezao je prisutne simptome s opsežnim restauracijskim zahvatima. Primjetio je da mu se smanjuje vertikalni prijeklop prednjih zubi nakon restauracijskih zahvata, što je uzrokovano trošenjem zubi. Na prikazu magnetske rezonancije lijevog temporomandibularnog zgloba prikazane su degenerativne promjene sa subhondralnom sklerozacijom u području zglobne kvržice i anterioni pomak zglobne pločice. Nakon uspješne inicijalne terapije okuzijskom udlagom omogućena je definitivna protetska terapija. Nakon tri godine na snimkama magnetske rezonancije prikazan je nepromjenjeni status temporomandibularnih zglobova, iako pacijent nije imao recidiv simptoma temporomandibularnog poremećaja. Niti remodelacijske promjene na kondilu nisu utjecaje na eventualno pogoršanje funkcijskog stanja. This case report describes the complex prosthodontic rehabilitation of a 45 year-old male patient by using an occlusal splint as a means of initial treatment for neuromuscular reprogramming, for repositioning of the condyle within the mandibular fossa to obtain occlusal stability and thus allowing adaptation to a new occlusal vertical dimension (OVD). The patient had experienced temporomandibular joint (TMJ) symptoms, which were more pronounced in the left TMJ. He connected the occurrence of symptoms with extensive prosthetic restoration. He had noticed lowering of the vertical overlap of the front teeth after restorative treatments, which was exacerbated by tooth wear. The appearance of the left TMJ by means of magnetic resonance imaging (MRI) showed degenerative changes with subchondral sclerosation in the area of the articular eminence, and anterior disc displacement. Definitive prosthodontic treatment was made possible by the successful initial treatment with the splint. Three years later the MRI showed unchanged status of TMJ although the patient did not have recurring TMD symptoms. Even the remodeling alterations on the condyle did not affect the possible deterioration of the functional condition.

osteoarthritis; tempoormandibular joint; prosthetic therapy

nije evidentirano