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Clinical-physiological indices in masticatory muscle dysfunction


Author: Bordeniuc Gheorghe
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2023
Scientific advisers: Valeriu Fala
doctor habilitat, associate professor (docent)
Victor Lacusta
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 25 January, 2023 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.04 Mb / in romanian
Adobe PDF document0.94 Mb / in english

Thesis

CZU 616.742.7-008.6-07(043.2)

Adobe PDF document 5.49 Mb / in romanian
159 pages


Keywords

temporomandibular disorders, masticatory muscle dysfunctions, clinical-physiological indices, diagnosis

Summary

Thesis structure. The text of the thesis is presented on 120 pages of basic text, processed on the computer, consisting of: list of abbreviations, introduction, 5 chapters, general conclusions, practical recommendations, bibliography from 288 sources and 4 appendices. The illustrative material includes 23 tables, 15 figures and 7 formulas.

The purpose of the work: Studying the particularities of masticatory muscle dysfunctions (clinical variant, disease phase) based on the enhancement of the DC/TMD protocol with local, regional and systemic clinical-physiological indices.

Research objectives: Study of the activity of the stomatognathic system in patients with dysfunctions of the masticatory muscles according to the phase of the disease and the clinical variant. Highlighting, based on the mathematical-statistical analysis, of the distinct clinical patterns of masticatory muscle disorders based on local, regional, systemic clinical-physiological indices and the potential therapeutic impact of occlusal splints in rehabilitating the functionality of the stomatognathic system. Studying the peculiarities of generalized disorders within the clinical subtypes of masticatory muscle dysfunction. Study of masticatory performance based on subjective and objective indices in different clinical subtypes of masticatory muscle dysfunction. Development of integral parameters for the assessment of pain manifestations in the stomatognathic system in patients with dysfunctions of the masticatory muscles.

Scientific novelty and originality: For the first time, indices of the activity of the stomatognathic system were highlighted, that are statistically significantly associated with the clinical variant of masticatory muscle dysfunction, the phase of the disease and common indices for both criteria. For the first time, based on the mathematical-statistical analysis, the clinical manifestations were identified, which can differentiate patients with masticatory muscle dysfunctions into 2 distinct clinical patterns (regional, regionalgeneralized) based on the extent and severity of the disorders. The structure and severity of quantitative and qualitative indices of masticatory muscle dysfunctions are dependent on the phenomenon of fibromyalgianess. The assessment of masticatory function requires the simultaneous evaluation of objective and subjective indices, which describe different aspects of masticatory performance in patients with masticatory muscle dysfunction. For the first time, sensory hypersensitivity has been shown to be an informative criterion, characteristic of clinical subtypes of masticatory muscle dysfunction. For the first time, a masseter muscle pain mapping method was proposed with the assessment of the relative heterogeneity index of the pain map. For the first time, it has been shown that operational stress modeling allows highlighting the change in pain tolerance and resistance of the masseter muscle, which does not change essentially in relative comfort conditions in patients with masticatory muscle dysfunctions.

Practical importance: The clinical structure and expression of masticatory muscle dysfunction depends on the clinical variant, the disease phase and the generalization of symptoms. Differentiated assessment of the masticatory function can be achieved by applying subjective and objective indices of the mixing ability assessment test in patients with masticatory muscle dysfunctions. Personalization of the diagnosis of masticatory muscle dysfunctions depending be made based on the indices of sensory hypersensitivity. The diagnostic value of experimental modeling of operational stress and its impact on quantitative-sensory indices in patients with masticatory muscle dysfunctions was determined. For the first time, a loco-regional pain examination technology was developed, by analyzing the heterogeneity of the spatial distribution of mechanical pain sensitivity of the masseter muscle.

Implementation of scientific results. The results of scientific research were implemented in the research process, methodological and clinical activity at the Fala Dental Clinic, Megalux Dent Clinic, IM Municipal Dental Center, in the didactic training process at the Department of Therapeutic Dentistry of USMF "Nicolae Testemițanu".