[Contributions to the methodology of study in the functional assessment of temporomandibular joint dysfunctional syndrome].
OBJECTIVE
Dysfunctional syndrome of the temporomandibular joint through the complexity and variability of the symptoms may result in significant structural and functional changes leading from discomfort to disability and a negative impact on quality of life.


METHODS
A prospective study was conducted between October 2009-December 2010, in 52 subjects diagnosed with rheumatoid arthritis and complaining of symptoms in the temporomandibular joint. The functional examination of the joint and muscle has included the assessment of the active range of motion, passive range of motion, resistance range of motions of the temporomandibular joint, dermatomes and the pain in the region of masseter, temporalis, median and lateral pterigoids, digastric, sternocleidomastoid and longus colli muscles. The ultrasound examination has included clinical aspects of alignment, shape, dynamics of the mandibular condyle, of the temporal fossa, aspects regarding the temporal and masseter muscles at rest and at contraction phases.


RESULTS
The clinical examination highlighted the presence of pain at temporomandibular jointlevel for all tested pacients. The majority complained the pain from moderate to severe level. For the majorityof cases (59,60%) the pain stars spontaneously, during the day time (80,80%) and the night time (50,60%). Over 50% from the research cases complained cracks at the temporomandibular joint level released by a movement. At the oral and dental examination of the research group 55,8% from the tested pacients presented dental cavities toothless partially or totally duet o additionally overworking temporomandibular joint. The limitation of the range of motion is not the most important detected dysfunction, affecting approximately 30% of the cases that have been studied. Pain and spasm in a very large proportion are present in the masseter and temporal muscles regions. Atrophy is present in a lesser extent. The dysfunctional index shows an involvement of the temporomandibular joint, for over 45% of patients tested. The ultrasound examination revealed degenerative inflammatory lesions at a rate of 38.46%, inflammatory lesions at a rate of 28.85% and mixed lesions at a rate of 9.62%.


CONCLUSIONS
The research regarding the clinical paraclinical and functional aspects of temporomandibular joint, permited to highlight the fact that rheumatic inflamatory and degenerative, pathology, characterises it self through a high index of morbidity and disability that lowers the life quality. Establishing a treatment plan involves customizing all clinical, functional and laboratory data.
Facultatea de Medicină Dentară, Universităţii de Medicină şi Farmacie "Grigore T. Popa"--Iaşi.
Maria Daniela
MD
Havriş
Cristina
C
Iordache
Codrina
C
Ancuţa
Rodica Marieta
RM
Chirieac
D000328:Adult; D000368:Aged; D000465:Algorithms; D018771:Arthralgia / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013703:Temporal Muscle / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography