Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Temporomandibular Eklem Düzensizliği Hastalarının Teşhis ve Tedavilerinin Demografik Özelliklerine Göre İncelenmesi
Investigation of Diagnosis-Treatment of Temporomandibular Joint Disorder Patients According to Demographic Variables
Tuğgen ÖZCİVELEK MERSİNa, Fulya BASMACIb, Selva LATİFOĞLUc
aSağlık Bilimleri Üniversitesi Gülhane Ağız ve Diş Sağlığı Merkezi, Ankara, TÜRKİYE
bT.C. Sağlık Bakanlığı Türkiye İlaç ve Tıbbi Cihaz Kurumu, Ankara, TÜRKİYE
cSağlık Bakanlığı 75. Yıl Ankara Ağız ve Diş Sağlığı Hastanesi, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(1):58-66
doi: 10.5336/dentalsci.2019-65463
Article Language: TR
Full Text
ÖZET
 Amaç: Temporomandibular eklem düzensizlikleri (TMED); toplumda sık görülen, etiyolojik faktörleri çeşitlilik gösteren rahatsızlıklardır. Bu çalışmanın amacı şakak, yüz ve çene eklemindeki sorunlar nedeni ile kliniğimize başvuran hastaların muayeneleri sonucundaki teşhis ve tedavilerini demografik verilerine göre incelemektir. Gereç ve Yöntemler: Ankara 75. Yıl Ağız Diş Sağlığı Hastanesi TMED Kliniği'ne şakak, yüz, çene ekleminde ağrı, hareket kısıtlaması şikâyetiyle başvuran yaş aralığı 18-70 yıl olan 196 hastanın bilateral TME, çiğneme kasları muayene edildi. Muayene bulguları, demografik veriler muayene formuna kaydedildi. Teşhisler kas kökenli eklem rahatsızlığı (KK), disk düzensizliği (DD) ve dejeneratif eklem hastalığı (DEH) olmak üzere üç grupta incelendi. Jacobs'un progresif gevşeme tekniği, hastalığı önleyici yaklaşımlara ilişkin eğitim, farmakolojik tedavi, sıcak/soğuk kompres, egzersiz programı, sert stabilizasyon splinti tedavileri uygun kombinasyonlarda uygulandı. Demografik verilere göre teşhis ve tedavilerin dağılımları, teşhise göre verilen tedavilerin dağılımları karşılaştırıldı. İstatistiksel analizde ki-kare testi kullanıldı. Bulgular: Yaş ortalaması 39,23±13,74; kadın:erkek oranı 3,1: 1 idi. Teşhislere göre cinsiyetler arasındaki fark anlamlı bulunmadı. Hastaların %50,5'inde KK, %29,6'sında DD, %5,1'inde DEH teşhis edildi. KK olan hastalara sıcak/soğuk kompres, farmakolojik tedavi ve stabilizasyon splinti tedavileri; DD olan hastalara ise egzersiz ve farmakolojik tedavi istatistiksel olarak fazla uygulandı. Demografik verilere göre DD teşhisi konan bireylerin %75,9'unun 18-45 yaş grubunda, %53,4'ünün bekâr, %72,4'ünün lise/üstü eğitime sahip olduğu ve farkın istatistiksel olarak anlamlı olduğu görüldü. KK ve DEH teşhisi olan hastalarda demografik verilere göre anlamlı ilişki saptanmadı. Sonuç: Kliniğimize başvuran hastalar içinde kadın hastaların ve KK oranının yüksek olduğu görüldü. KK olanlara sıcak/soğuk kompres, farmakolojik tedavi ve stabilizasyon splinti tedavilerinin; DD olanlara ise egzersiz tedavisi ve farmakolojik tedavinin daha fazla uygulandığı tespit edildi.

Anahtar Kelimeler: Temporomandibular eklem; temporomandibular eklem düzensizliği; miyofasiyal ağrı
ABSTRACT
 Objective: Temporomandibular joint disorders (TMJD) are common in community with various etiologic factors. Aim of this study was to investigate diagnosis, treatment of patients according to demographic data, referred to our clinic with pain in the temples, face, TMJs. Material and Methods: 196 (18-70 years) patients admitted to our TMJD Clinic were examined bilaterally for pain in TMJs and masticatory muscles. Findings and demographic data were recorded to examination form. The diagnoses were evaluated in three groups: Muscle disorders(MD), disc displacement(DD) and degenerative joint disease (DJD). For management; preventive measures training, Jacobs's progressive relaxation technique, pharmacologic treatment, hot/cold compress, exercise, stabilization splints were applied in appropriate combinations. Distribution of diagnosis and treatments with respect to demographic variables and distribution of treatments with respect to diagnosis were investigated. Data was analysed with chi-square test. Results: Mean age of the study group was 39.23±13.74; female:male ratio was 3.1:1. No statistically significant difference was detected between genders with respect to diagnosis. MD, DD, DJD were diagnosed in 50.5%, 29.6%, 5.1% of the patients, respectively. Hot/cold packs, medication, stabilization splint treatments were more prevalent in MD; exercise and medication were higher in DD patients. Of the individuals diagnosed with DD, 75.9% were in 18-45 age group, 53.4% were single, 72.4% had higher education level with statistically significant differences.Demographic variables displayed no relation in MD and DJD patients. Conclusion: Female gender and MD was most common among our patients. Treatment applied in MD were predominantly hot/cold packs, medication, stabilization splint treatments while in DD patients exercise and medication were higher.

Keywords: Temporomandibular joint; temporomandibular joint disorders; myofacial pain
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