Identification of risk factors for TMJ symptoms as a result of prolonged therapeutic dental treatment

The Aim of the study: to identify risk factors for the occurrence of symptoms of temporomandibular joint disorders (TMDs) as a result of long-term dental treatment in a predisposed population Material and methods. The study was approved by the Ethics Committee of the Medical Institute of RUDN University, protocol No 12 dated November 17, 2022, 163 patients over 18 years of age with a diagnosis according to ICD-10 K07.6 Diseases of the temporomandibular joint (TMJ) were examined. After excluding patients with dentition defects, as well as with periodontal diseases accompanied by tooth mobility, 94 patients remained. All patients were questioned. The questionnaire was provided for filling out in paper form and included 11 questions. Then a clinical examination was carried out. The data obtained were analyzed statistically using the software StatTech v. 4.0.6. Results and discussions. Among the examined patients, 86 (91,5 %) had at least one restored first molar, 8 (8,5 %) did not have restorations in the area of the first molars. Patients who noted the TMJ crunching belonged to the older age group (Me 37.0 [Q₁ 32,5 – Q₃ 49,5]). Among patients who reported symptom during dental treatment, 37,5 % were during endodontic treatment lasting more than 60 minutes. Whereas with the duration of this procedure less than 60 minutes, cases of symptom appearance or intensification were noted by 25,0 % of patients. Women indicated the onset of symptoms more often than men. The number of restored first molars is significantly higher in those patients who have a complaint of crunching compared to those who did not indicate such a complaint. Cases of TMJ crunching were reported in patients in whom all four first molars had restorations with the index of occlusal surface destruction (IROPZ) ˃ 0,4. All data were statistically significant. Conclusions. Based on the study, it can be concluded that patients diagnosed with K07.6. Diseases of the temporomandibular joint, the likelihood of having complaints of crunching in the TMJ area increases after the age of 31, as well as in the presence of restorations in the area of all four first molars. Endodontic treatment lasting more than 60 minutes may cause the onset or worsening of TMJ symptoms, especially in patients with restorations with the index of occlusal surface destruction (IROPZ) ˃ 0,4 in all first molars. The data obtained will help dentist to assess the risk in advance and prevent the development/worsening of TMDs symptoms during long-term therapeutic dental treatment of the predisposed population.