NEUROMUSCULAR DENTISTRY’S PLACE IN DENTAL PRACTICE

Аннотация

Diagnosis and treatment of temporomandibular joint (TMJ) dysfunction and related chronic facial pain syndromes
can be very challenging in modern dentistry. When underlying neuromuscular involvement and muscle hypertonicity
are not treated, conventional isolated prosthodontic or orthodontic procedures often do not provide sustained
clinical effects.
Goal: To assess the diagnostic and therapeutic approaches used in neuromuscular dentistry, with emphasis on the clinical
efficacy of custom-made splint therapy and transcutaneous electrical nerve stimulation (TENS) in the treatment of painful
temporomandibular joint dysfunction syndrome.
Materials and Methods: Based on an empirical analysis of a typical clinical case, a detailed analysis of the recent academic
literature and clinical recommendations was carried out. A neuromuscular approach was used to treat a 68-year-old
female patient with chronic painful TMJ dysfunction syndrome, which is characterised by joint crepitus, limited mandibular
movement, anterior open bite, tinnitus, and severe recurrent headaches. The treatment protocol was the use of transcutaneous
electrical nerve stimulation (TENS) and a specific lower-arch acrylic device (“Orthotic”) to re-establish the vertical
dimension of occlusion (VDO) and re-establish the natural mandibular position.
Results of the Research: Targeted myorelaxation with TENS successfully stopped aberrant nociceptive pathways, eased
spasms in the masticatory muscles, and allowed accurate registration of the mandible’s physiological neuromuscular
position. The long-term orthotic splint treatment resulted in effective stabilisation of occlusal contacts, elimination of joint
sounds and chronic pain symptoms, recovery of limited jaw motions, and long-term functional stability without recurrence
of symptoms.
Conclusion: A thorough, multidisciplinary approach that concurrently treats articular structures, occlusal connections, and
the surrounding masticatory musculature is necessary for the effective therapy of TMJ dysfunction. The use of modern
neuromuscular modalities, such as TENS, specific orthotic appliances, and joint sonography, greatly improves the longterm
prognosis and diagnostic accuracy in difficult occlusal rehabilitation.