PREVALENCE OF TEMPOROMANDIBULAR JOINT DISORDERS AND GENDER- ASSOCIATED SPECIFICS OF THE INTERNAL PICTURE OF DISEASE FORMATION
DOI:
https://doi.org/10.11603/2311-9624.2026.1.16336Keywords:
temporomandibular joint, internal picture of the disease, temporomandibular disorders, gender features, quality of life, biopsychosocial model, OHIP-14.Abstract
Despite significant technological progress in modern gnathology, the recurrence rate and dissatisfaction with treatment outcomes among patients with temporomandibular joint disorders remain high. This dictates the necessity of transitioning from a reductionist biomechanical paradigm to a biopsychosocial model, taking into account the sexual dimorphism of etiopathogenesis and the specific features of the internal picture of the disease formation. Objective. To study the prevalence of temporomandibular joint disorders and establish the specific features of the internal picture of the disease formation in patients of different genders for the development of personalized approaches to comprehensive rehabilitation. Materials and Methods. A comprehensive clinical and instrumental examination of 215 individuals was conducted. The main group consisted of 168 patients (94 females, 74 males) with verified temporomandibular joint disorders according to the Diagnostic Criteria for Temporomandibular Disorders, 2014 (DC/TMD). The evaluation of the internal picture of the disease and quality of life was performed using the validated Oral Health Impact Profile questionnaire (OHIP-14; Slade G.D., 1997). Statistical analysis was carried out in the Statistica 13.0 software utilizing Student’s t-test, the Mann- Whitney U test, and Pearson’s c2 test. Results and Discussion. Articular disc dislocations were diagnosed in 41.07 % of the patients, muscle disorders in 33.33 %, and degenerative- inflammatory changes in 25.60 %. Gender patterns of the clinical course were revealed: women showed a tendency toward a higher frequency of myofascial disorders (36.17 % vs. 29.73 % in men), whereas intra- articular dislocations prevailed in men (44.59 % vs. 38.30 %). The analysis of the internal picture of the disease using OHIP-14 demonstrated that women exhibit a significantly higher level of psychosocial maladaptation in muscle disorders – by 24.80 %, p < 0.05, and disc dislocations – by 23.64 %, p < 0.05. At the stage of degenerative changes, the gender difference in quality of life indicators is leveled out, p > 0.05. Conclusions. Temporomandibular joint disorders are characterized by clear nosological and gender determinism. The subjective perception of the internal picture of the disease significantly outweighs the objective morphological picture, especially in the female population, which is accompanied by profound maladaptation. This proves the necessity of integrating psychosomatic profiling into the management protocol for gnathological patients within the framework of precision medicine.
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