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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2002 December;161(6):213-6

language: Italian

Joint disease and muscle pain: a different therapuetical approach

Pierleoni F., Gizdulich A.

Dipartimento di Odontostomatologia, Università degli Studi di Firenze, Firenze


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Craniomandibular disorders may affect both the temporo-mandibular joints and the neuromuscular system. Myofacial pain is the most frequent symptom and mainly involves the head and neck area. Some patients, however, only present signs and symptoms of temporo-mandibular joint disease. Our school has proposed a 3-degree classification of the disorders in order to plan the correct therapy. Clinical inspection highlights the muscle suffering and articular sounds which are an expression of articular injury that can alter mandibular movements. In this way we can recognize from the very beginning when the improvement of temporo-mandibular joint function is needed. Our experience suggests treating patients affected by tensive headache with orthopaedic therapy. These symptoms must be investigated with electromyography and kinesiography instruments so as to quantify muscle injury and pathological dental occlusion in order to correct it with an intraoral device: the orthosys.
Whenever major articular damage is evident, orthopedic treatment cannot be sufficient to treat temporo-mandibular joint function and an intraoral appliance is needed to mantain a mandibular protrusion. The hypercorrection of this kind of disease allows us to determine an improvement in the opening and closing movements of the mouth with no articular sounds.
When the temporo-mandibular tissues are adjusted as well as possible the physiological dental occlusion can be reached and mantained with the orthosys in order to correct the muscular unbalance.

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