Temporomandibular Bozukluklar ve Güncel Tedavi Yaklaşımları
Synopsis
Temporomandibular eklem (TME) diğer bir tanımla kraniomandibular artikülasyon, üç boyutlu hareket özgürlüğü ile mandibulaya açma, kapama, retrüzyon, protrüzyon ve translasyon hareketlerini yaptıran top-soket tipi bir eklemdir. Toplumun %60-70 gibi bir bölümünün en az bir semptomunu yaşadığı Temporomandibular bozukluklar (TMB), uyku kalitesini, sosyal aktiviteleri, emosyonel ve bilişsel durumları olumsuz etkileyerek yüksek anksiyete ve düşük yaşam kalitesine de sebep olmaktadır. Etyolojide net anlaşılamayan durumlar olduğundan TMB tedavisinde bazen zorluk çekilmektedir. Teşhisde etyolojik faktörler ve risk faktörlerini irdelemek, koruyucu ve tedavi edici yöntemler belirleyecek şekilde kapsamlı bir klinik değerlendirme gerekmektedir. Hasta eğitimi, egzersiz ve elektroterapi uygulamaları, eklem içi girişimsel yaklaşımlar tedavi seçenekleridir.
References
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Piette E. Anatomy of the human temporomandibular joint. An updated comprehensive review. Acta Stomatol Belg. 1993 Jun;90(2):103-27. PMID: 8237635.
Wadhokar OC, Patil DS. Current Trends in the Management of Temporomandibular Joint Dysfunction: A Review. Cureus. 2022 Sep 19;14(9): e29314. doi: 10.7759/cureus.29314. PMID: 36277551; PMCID: PMC9579904.
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Alomar X, Medrano J, Cabratosa J, et al. Anatomy of the temporomandibular joint. Semin Ultrasound CT MR. 2007 Jun;28(3):170-83. doi: 10.1053/j.sult.2007.02.002. PMID: 17571700.
Orhan K. Temporomandibular eklemin anatomisi. 13/02/2023 https://acikders.ankara.edu.tr/pluginfile.php/69345/mod_resource/content/0/pdf/Temporomandibular Eklemnot.pdf adresinden ulaşılmıştır
Ferrario VF, Sforza C, Miani A Jr, et al. G. Open-close movements in the human temporomandibular joint: does a pure rotation around the intercondylar hinge axis exist? J Oral Rehabil. 1996 Jun;23(6):401-8. doi: 10.1111/j.1365-2842.1996.tb00871.x. PMID: 8809695.
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Güreser G. Temporomandibular joint disorders. Fiziksel Tıp 2003; 6(2): 37-45.
Taşkıran ÖÖ. Temporomandibular bozukluklar in Beyazova M, Kutsal YG (Eds.) Fiziksel Tıp ve Rehabilitasyon; Ankara; Güneş tıp Kitabevleri, 2011. p 1955-1980.
Chisnoiu AM, Picos AM, Popa S, et al. Factors involved in the etiology of temporomandibular disorders - a literature review. Clujul Med. 2015;88(4):473-8. doi: 10.15386/cjmed-485. Epub 2015 Nov 15. PMID: 26732121; PMCID: PMC4689239.
Dworkin SF, Huggins KH, LeResche L, et al. Epidemiology of signs and symptoms in temporomandibular disorders: clinical signs in cases and controls. J Am Dent Assoc. 1990 Mar;120(3):273-81. doi: 10.14219/jada.archive.1990.0043. PMID: 2312947.
Yildiz S, Balel Y, Tumer MK. Evaluation of prevalence of temporomandibular disorders based on DC / TMD Axis I diagnosis in Turkish population and correlation with Axis II. J Stomatol Oral Maxillofac Surg. 2023 Feb;124(1S):101303. doi: 10.1016/j.jormas.2022.10.002. Epub 2022 Oct 4. PMID: 36207001. Volume 124, Issue 1, Supplement, February 2023, 101303.
Okeson JP. Management of Temporomandibular Disorders and Occlusion. 8th edition. Elsevier Health Science.
Kapos FP, Exposto FG, Oyarzo JF, et al. Temporomandibular disorders: a review of current concepts in aetiology, diagnosis and management. Oral Surg. 2020 Nov;13(4):321-334. doi: 10.1111/ors.12473. Epub 2020 Jan 25. PMID: 34853604; PMCID: PMC8631581.
Laskin DM. Temporomandibular Joint Pain. In Ruddy S, Harris ED, Sledge GB (Eds): Kelly’s textbook of Rheumatology. Philedelphia, W.B. Saunders Co.2001, p 557-567.
Milam SB. Pathogenesis of degenerative temporomandibular joint arthritides. Odontology. 2005 Sep;93(1):7-15. doi: 10.1007/s10266-005-0056-7. PMID: 16170470.
Carroll LJ, Ferrari R, Cassidy JD. Reduced or painful jaw movement after collision-related injuries: a population-based study. J Am Dent Assoc. 2007 Jan;138(1):86-93. doi: 10.14219/jada.archive.2007.0026. PMID: 17197407.
Abubaker AO, Raslan WF, Sotereanos GC. Estrogen and progesterone receptors in temporomandibular joint discs of symptomatic and asymptomatic persons: a preliminary study. J Oral Maxillofac Surg. 1993 Oct;51(10):1096-100. doi: 10.1016/s0278-2391(10)80448-3. PMID: 7692023.
Hashem G, Zhang Q, Hayami T, et al. Relaxin and beta-estradiol modulate targeted matrix degradation in specific synovial joint fibrocartilages: progesterone prevents matrix loss. Arthritis Res Ther.2006;8:R98. [PubMed: 16784544]
Bi Y, Stuelten CH, Kilts T, et al. Extracellular matrix proteoglycans control the fate of bone marrow stromal cells. J Biol Chem. 2005 Aug 26;280(34):30481-9. doi: 10.1074/jbc.M500573200. Epub 2005 Jun 17. PMID: 15964849.
Baeshen HA. Malocclusion trait and the parafunctional effect among young female school students.Saudi J Biol Sci. 2021 Jan; 28(1): 1088–1092. doi: 10.1016/j.sjbs.2020.11.028
Jiménez-Silva A, Peña-Durán C, Tobar-Reyes J, et al. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014. Acta Odontol Scand. 2017 Jan;75(1):36-58. doi: 10.1080/00016357.2016.1247465. Epub 2016 Oct 31. PMID: 27796166.
Ulay G, Namdar Pekinel F. Temporomandibular eklem disfonksiyonlu bir grup hastada klinik bulguları. Selcuk Dental Journal. 2019; 6(4): 287-293.
Ferreira LA, Grossmann E, Januzzi E, et al. Diagnosis of temporomandibular joint disorders: indication of imaging exams. Braz J Otorhinolaryngol. 2016 May-Jun;82(3):341-52. doi: 10.1016/j.bjorl.2015.06.010. Epub 2016 Jan 8. PMID: 26832630; PMCID: PMC9444643.
Sivam S, Chen P. Anatomy, Occlusal Contact Relations And Mandibular Movements. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570625/
Hwang IT, Jung DU, Lee JH, et al. Evaluation of TMJ sound on the subject with TMJ disorder by Joint Vibration Analysis. J Adv Prosthodont. 2009 Mar;1(1):26-30. doi: 10.4047/jap.2009.1.1.26. Epub 2009 Mar 31. PMID: 21165251; PMCID: PMC2994670.
Kurt H, Mumcu E, Ateş M. Temporomandibular rahatsızlıkların teşhisinde temporomandibular rahatsızlıklar / araştırma teşhis kriterlerinin (TMR/ATK) kullanımı. Journal of Istanbul University Faculty of Dentistry. 2012; 40(1-2): 1-5.
Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature. Medicina (Kaunas). 2020 May 9;56(5):225. doi: 10.3390/medicina56050225. PMID: 32397412; PMCID: PMC7279162.
Wassef HR, Colletti PM. Nuclear Medicine Imaging in the Dentomaxillofacial Region. Dent Clin North Am. 2018 Jul;62(3):491-509. doi: 10.1016/j.cden.2018.03.008. PMID: 29903564.
Martins WR, Blasczyk JC, Aparecida Furlan de Oliveira M et al. Efficacy of musculoskeletal manual approach in the treatment of temporomandibular joint disorder: A systematic review with meta-analysis. Man Ther. 2016 Feb;21:10-7. doi: 10.1016/j.math.2015.06.009. Epub 2015 Jun 25. PMID: 26144684.
Wieckiewicz M, Boening K, Wiland P, et al. Reported concepts for the treatment modalities and pain management of temporomandibular disorders. J Headache Pain. 2015;16:106. doi: 10.1186/s10194-015-0586-5. Epub 2015 Dec 7. PMID: 26644030; PMCID: PMC4671990.
Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin North Am. 2013 Jul;57(3):465-79. doi: 10.1016/j.cden.2013.04.006. PMID: 23809304.
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April 3, 2023
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Akın T. Temporomandibular Bozukluklar ve Güncel Tedavi Yaklaşımları. In: Kelle B, editor. Fizik Tedavi ve Rehabilitasyonda Güncel Konular [Internet]. Türkiye: Academician Publishing Book DOI Portal; 2023 [cited 2026 Jul. 16]. pp. 1-32. Available from: https://omp35.books.akademisyen.net/index.php/akya/catalog/book/2533/chapter/13789
