hrvatski

Bol temporomanibularnog zgloba s aspekta javnog zdravstva

Cilj Temporomandibularni poremećaji su skup funkcijskih poremećaja žvačnih mišića i temporomandibularnim zglobova (TMZ). Za TMZ najvažnija je raspodjela na dijagnoze anteriorni pomak diska (adhezija, posteriorni pomak kao i perforacija diska su iznimno rijetke), osteoartritis (degenerativa artroza) i sinovijalitis (nalaz upalne tekućine bez druge patologije). Vlastito istraživanje TMZ-a. Pacijentima osim kliničkom dijagnostikom postavljena je definitivna dijagnoza poremećaja TMZ-a temelje MR-a. Utvrđena je značajna razlika starosti pacijenata ovisno o tome da li su imali dijagnozi pomaka diska ili osteoartritis. Prosječna dob pacijenata s osteoartritisom (48, 8 god.) je veća nego u onih s pomakom diska (32, 5 god.). Tegobe TMZ-a javljaju se najčešće u žena dobi od 20-45 godina. Neurološkom specijalistikom potvrđena prevalencija komorbiditeta s drugim orofacijalnim tegoba: perzistentna bol lica rijetka u pacijenata s pomakom diska (0, 7%), kao i neuralgija trigeminusa (1, 5%), a češće su u pacijenata s osteoartitisom: perzistentna bol lica kod 10, 4% i neuralgija trigeminusa kod 9% pacijenata. Planiranje zdravstvene skrbi. Ciljanom organizacijom zdravstvene usluge pacijentima s tegobama TMZ-a u okviru javnog i privatnog zdravstvenoga osiguranja postiglo bi se optimalno korištenje zdravstvenih ekonomskih resursa. Izradba oralne ortoze (okluzijske udlage) i njome postizanje terapijske okluzije u svrhu simptomatske terapije žvačnoga sustava prvenstvena su domena stomatološke protetike. Fizioterepija je dio fizijatrijskih mogućnosti liječenja TMZ-a. Zaključak. MR je zlatni standard u dijagnostici mekih tkiva (status diska, nalaz upalnog izljeva), ali za dijagnostiku tvrdih tkiva, kod osteoartritsa, najbolja je primjena cone beam kompjuterizirane tomografije. Izbor kliničkih i drugih dijagnostičkih postupaka kao i povezanost s drugim specijalistima medicine osnova su uspješnog zdravstvenog zbrinjavanja pacijenata s muskuloskeletalnim dijagnozama TMZ-a. Objectives: Temporomandibular joint (TMJ) disorders refer to a set of function disorders of muscles of mastication, and temporomandibular joints (TMJs). A distribution of diagnoses such as the anterior displacement of the disc (adhesion, posterior displacement as well as perforation of the disc are extremely rare), osteoarthritis (degenerative arthrosis) and synovialitis (finding of inflammatory fluid without other pathology) is of utmost importance to TMJ. Research on TMJ: Apart from obtaining a clinical diagnosis, the patients received a final diagnosis of TMJ based on magnestic resonance imaging (MRI). A significant age difference was determined depending on whether they had disc displacement or osteoarthritis. The average age of patients with osteoarthritis (48.8 years) is higher than of those with disk displacement (32.5 years). TMJ disorders most commonly affect women aged 20–45 years. During the neurological exam, the specialist confirmed the prevalence of comorbidity with other orofacial disorders: persistent facial pain is rare in the patients with displacement of the disc (0.7%) as well as trigeminal neuralgia (1.5%), and it occurs more often in patients with osteoarthritis: persistent facial pain in 10, 4% of patients, and trigeminal neuralgia in 9% of patients. Health Care Planning: An optimal use of health economical resources could be achieved by providing targeted healthcare services to patients with TMJ disorders within the public and private health insurance. The fabrication of oral orthotics (occlusal splint) in order to achieve therapeutic occlusion for the purpose of symptomatic therapy of masticatory system is primarily the domain of dental prosthetics. A physical therapy is part of physiotherapy potential for the treatment of TMD patients. Conclusion: MRI is the golden standard in soft tissue diagnostics (disc status, ongoing inflammatory discharge), however, cone beam computed tomography is recommended as diagnostic modality in hard tissue diagnostics of TMJ such as osteoarthritis. The choice of clinical and other diagnostic procedures as well as connection with other medical specialists are the basis of successful health care for patients with TMJ musculoskeletal diagnoses.

temporomandibularni zglob ; magnetska rezonancija ; javno zdravstvo

nije evidentirano

engleski

Pain of the temporomandibular joint from the aspect of public health

Cilj Temporomandibularni poremećaji su skup funkcijskih poremećaja žvačnih mišića i temporomandibularnim zglobova (TMZ). Za TMZ najvažnija je raspodjela na dijagnoze anteriorni pomak diska (adhezija, posteriorni pomak kao i perforacija diska su iznimno rijetke), osteoartritis (degenerativa artroza) i sinovijalitis (nalaz upalne tekućine bez druge patologije). Vlastito istraživanje TMZ-a. Pacijentima osim kliničkom dijagnostikom postavljena je definitivna dijagnoza poremećaja TMZ-a temelje MR-a. Utvrđena je značajna razlika starosti pacijenata ovisno o tome da li su imali dijagnozi pomaka diska ili osteoartritis. Prosječna dob pacijenata s osteoartritisom (48, 8 god.) je veća nego u onih s pomakom diska (32, 5 god.). Tegobe TMZ-a javljaju se najčešće u žena dobi od 20-45 godina. Neurološkom specijalistikom potvrđena prevalencija komorbiditeta s drugim orofacijalnim tegoba: perzistentna bol lica rijetka u pacijenata s pomakom diska (0, 7%), kao i neuralgija trigeminusa (1, 5%), a češće su u pacijenata s osteoartitisom: perzistentna bol lica kod 10, 4% i neuralgija trigeminusa kod 9% pacijenata. Planiranje zdravstvene skrbi. Ciljanom organizacijom zdravstvene usluge pacijentima s tegobama TMZ-a u okviru javnog i privatnog zdravstvenoga osiguranja postiglo bi se optimalno korištenje zdravstvenih ekonomskih resursa. Izradba oralne ortoze (okluzijske udlage) i njome postizanje terapijske okluzije u svrhu simptomatske terapije žvačnoga sustava prvenstvena su domena stomatološke protetike. Fizioterepija je dio fizijatrijskih mogućnosti liječenja TMZ-a. Zaključak. MR je zlatni standard u dijagnostici mekih tkiva (status diska, nalaz upalnog izljeva), ali za dijagnostiku tvrdih tkiva, kod osteoartritsa, najbolja je primjena cone beam kompjuterizirane tomografije. Izbor kliničkih i drugih dijagnostičkih postupaka kao i povezanost s drugim specijalistima medicine osnova su uspješnog zdravstvenog zbrinjavanja pacijenata s muskuloskeletalnim dijagnozama TMZ-a. Objectives: Temporomandibular joint (TMJ) disorders refer to a set of function disorders of muscles of mastication, and temporomandibular joints (TMJs). A distribution of diagnoses such as the anterior displacement of the disc (adhesion, posterior displacement as well as perforation of the disc are extremely rare), osteoarthritis (degenerative arthrosis) and synovialitis (finding of inflammatory fluid without other pathology) is of utmost importance to TMJ. Research on TMJ: Apart from obtaining a clinical diagnosis, the patients received a final diagnosis of TMJ based on magnestic resonance imaging (MRI). A significant age difference was determined depending on whether they had disc displacement or osteoarthritis. The average age of patients with osteoarthritis (48.8 years) is higher than of those with disk displacement (32.5 years). TMJ disorders most commonly affect women aged 20–45 years. During the neurological exam, the specialist confirmed the prevalence of comorbidity with other orofacial disorders: persistent facial pain is rare in the patients with displacement of the disc (0.7%) as well as trigeminal neuralgia (1.5%), and it occurs more often in patients with osteoarthritis: persistent facial pain in 10, 4% of patients, and trigeminal neuralgia in 9% of patients. Health Care Planning: An optimal use of health economical resources could be achieved by providing targeted healthcare services to patients with TMJ disorders within the public and private health insurance. The fabrication of oral orthotics (occlusal splint) in order to achieve therapeutic occlusion for the purpose of symptomatic therapy of masticatory system is primarily the domain of dental prosthetics. A physical therapy is part of physiotherapy potential for the treatment of TMD patients. Conclusion: MRI is the golden standard in soft tissue diagnostics (disc status, ongoing inflammatory discharge), however, cone beam computed tomography is recommended as diagnostic modality in hard tissue diagnostics of TMJ such as osteoarthritis. The choice of clinical and other diagnostic procedures as well as connection with other medical specialists are the basis of successful health care for patients with TMJ musculoskeletal diagnoses.

temporomandibular joint ; magnetic resonance imaging ; publich health

nije evidentirano