Effectiveness of a new method for positioning the lower jaw in patients with partial tooth loss and temporomandibular joint dysfunction

Abstract

BACKGROUND: Temporomandibular joint (TMJ) dysfunction and partial tooth loss are common conditions among the population. The progression of these conditions and the insufficient effectiveness of diagnostic and treatment methods pose several challenges for modern dentistry. Numerous methods for determining the position of the lower jaw can be employed; however, comprehensive diagnostics are required for patients with these issues. Some diagnostic algorithms and treatment methods are unreliable. Studies have indicated that most treatment errors occur during the determination of the optimal lower jaw position.

AIM: To investigate the effectiveness of the developed method for lower jaw positioning in patients with partial tooth loss and TMJ dysfunction.

MATERIALS AND METHODS: This randomized controlled study enrolled 108 patients diagnosed with partial tooth loss and TMJ dysfunction. Patients were divided into three groups: group 1 underwent lower jaw positioning using transcutaneous electrical nerve stimulation, group 2 using a hydrostatic cap, and group 3 using the developed method. After establishing the lower jaw position, a stabilizing cap was fabricated for the patient to maintain the identified position for 60 days. Subsequently, the examination was repeated using the initial diagnostic algorithm, which included the same investigation methods.

RESULTS: Statistically significant changes were found in the morphofunctional state of the stomatognathic system in patients with partial tooth loss and TMJ dysfunction after applying various methods of lower jaw positioning, i.e., transcutaneous electrical nerve stimulation, hydrostatic cap, and the proposed method (p < 0.05). The symptoms diminished in all groups, and the greatest changes were observed in group 3. The analysis of cephalometric data showed a significant reduction in the displacement of the dental midline and sagittal dental distance and an increase in the vertical dental distance after lower jaw positioning. Electromyographic analysis revealed an increase in the symmetry of the temporal and masticatory muscles, torsion index, and masseteric center, particularly in group 3. The obtained data confirm the effectiveness of the proposed method for lower jaw positioning in improving the condition of the stomatognathic system in patients with partial tooth loss and TMJ dysfunction.

CONCLUSION: In comparison with existing methods, the proposed method of mandibular positioning improves the symmetry indices of temporal and masseter muscles, torsion index, and masseteric center to a greater extent, which contributes to the normalization of the TMJ articular gap parameters.

Keywords

temporomandibular joint / partial tooth loss / occlusal disorders / determination of central jaw relationship

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