Temporomandibular joint visualization in neuromuscular gnathology

Background. Enhancing the accuracy of jaw relationship assessment for occlusal rehabilitation remains a fundamental objective in functional dentistry. The mandibular position established for prosthetic restoration is considered definitive, whereas the jaw relationship before extended occlusal rehabilitation is often regarded as provisional. As a result, different approaches to managing temporomandibular joint (TMJ) dysfunction may be warranted. Evaluating the effectiveness of treatment methods for temporomandibular joint dysfunction through the analysis of computed tomography scans remains a relevant and important issue. Materials and methods. A clinical assessment was conducted on patients presenting with TMJ dysfunction symptoms, including clicking, popping, crepitus, and tenderness in the superficial masticatory muscles upon palpation. Patient history was also taken into account. Computed tomography (CT) scans were performed in habitual occlusion and in a jaw position obtained following masticatory muscle deprogramming using neuromuscular electrical stimulation. Additionally, analysis of dental arch models was conducted by assessing the position of the upper and lower central incisors. Results. CT analysis of the TMJ in 43 patients revealed a distal condylar position within the glenoid fossa. The ratio of the anterior to posterior joint spaces was 1 : 0.23–0.85, with the anterior joint space used as the reference unit. It was found that the dimensions of the anterior, superior, and posterior joint spaces varied following neuromuscular electrical stimulation: for right TMJ — accordingly, 1.32 ± 0.38 mm, 2.14 ± 0.35 mm, 2.12 ±0.35 mm, for left TMJ — 1.42 ± 0.38 mm, 2.12 ± 0.35 mm, 2.19 ± 0.37 mm (р = 0.05). Conclusions. Clinical evaluation and CT analysis confirmed the efficacy of a physiotherapeutic approach in treating TMJ dysfunction. The observed changes in condylar positioning following masticatory muscle deprogramming suggest that neuromuscular treatment protocols, including gnathological splints, may provide an optimal therapeutic outcome for managing TMJ dysfunction.