Frequency of diagnosing temporomandibular disorders in patients with fractures of the mandible depending on the localization and age
An increase in the number of injuries in the young able-bodied population is one of the main medical and social problems. Fractures of the bones of the face are characterized by a significant frequency, and the leading place is fractures of the mandible, ranging from 45 to 95 %. The main attention in domestic and foreign literature was directed at the study of internal disorders in the temporomandibular joint, due to fractures of the processus frontalis. Questions of the treatment of musculo – joint disorders caused by fractures of the mandible of other localizations, as a rule, were not addressed promptly and, accordingly, not resolved. This explains the relevance of the study.
The aim of the study – to analyze the frequency of temporomandibular disorders in patients with fractures of the mandible, depending on localization and age.
Materials and Methods. To achieve this goal we examined 164 patients hospitalized in Surgical Dentistry Department of Chernivtsi Regional Hospital with trauma fractures of the lower jaw, and processed patients’ cards contacting Maxillofacial Center in order to provide emergency medical care. For the determination of temporomandibular disorder, four symptoms were investigated, namely: pain in palpation of joints; presence of noise in the joints; pain in palpation of masticatory muscles; violation of the opening trajectory of the mouth. Statistical processing of research results was carried out using commonly used methods of variation statistics.
Results and Discussion. Among 164 patients with fractures of the mandible of a different localization, 111 patients were diagnosed with TMJ dysfunction: in 100% of the patients with fractures of the cervical area and coronary process of the mandible. Attention was drawn to the fact that in the middle and lateral parts of the mandible, the TMJ dysfunction was observed in 1.9 times and 1.5 times less frequently than in the case of fractures of the angle mandible. The frequency of temporomandibular disorders in patients with fractures of the mandible increased with age: from (34.38±8.40) % of patients aged 20–25 years to (77.50±6.60) % in 26–35 year olds, p <0.01 The maximum prevalence of TMJ dysfunction was observed in patients with jaw fractures in 36–45 years (89.19±5.10) %, p <0.01, p1> 0.05) and in the 46–55 year-old – (90.32±5.31) %, p <0.01, p1, p2, p3> 0.05. At the same time, in the patients of the older age group, the incidence of temporomandibulum disorder was (33.33±9.62) % and was equal to the data in individuals aged 20–25 years.
Conclusions. Thus, as a result of the research, it was found that the fractures of the mandible of different localization favor the development of disorders of the temporomandibular joint, the incidence of which was 67.68 %, with a 100 % prevalence in fractures of the cervical area and the coronary process of the mandible. At the same time, the maximum frequency of disturbances was observed in persons with fractures of the mandible of different localization at the age of 36–55 years and, on average was 89.76 %.
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