CLINICAL IMPROVEMENT THROUGH THE USE of ADVANCED METHODS IN THE TREATMENT OF TMJ IN PATIENTS WITH MANDIBULAR FRACTURES

Abstract

The painful form of temporomandibular joint (TMJ) dysfunction is one of the most common and serious consequences of traumatic mandibular injuries, particularly in the case of fractures. TMJ functional impairments significantly reduce patients' daily activity and quality of life, manifesting as severe pain during eating and speaking, limited mouth opening, clicking sounds, and asymmetry of mandibular movements.

The aim of this study was to evaluate the clinical effectiveness of a comprehensive therapeutic approach to the treatment of painful TMJ dysfunction in patients with mandibular fractures, with emphasis on early diagnosis, optimized immobilization techniques, restoration of occlusal relationships, and the use of physiotherapy and rehabilitation procedures. The study included 84 patients aged 18 to 60 years with diagnosed unilateral or bilateral fractures of the mandibular body and angle, accompanied by signs of TMJ dysfunction. The participants were divided into two groups, the main group (n = 43), which received a comprehensive therapeutic program, and the control group (n = 41), which received traditional treatment. The comprehensive therapy protocol included, accurate anatomical repositioning and fixation of bone fragments using miniplates, individually selected physiotherapeutic procedures (ultrasound therapy, magnetotherapy, electrical stimulation), early functional activation of the joint and psycho-emotional support to improve treatment adherence. Analysis of the collected data showed that in the main group, the duration required to relieve the pain syndrome was reduced by 35%. Restoration of mandibular movement range occurred on average within 2.5 weeks, compared to 4 weeks in the control group. Full symmetry of movement was achieved in 88% of patients in the main group, versus 68% in the control group. In addition, the rate of chronic TMJ dysfunction manifestations three months after treatment was significantly lower in the main group (7% versus 22%). The use of a multi-level, comprehensive approach to treating TMJ dysfunction in patients with mandibular fractures provides faster functional recovery, effective pain relief, and reduces the risk of chronic complications. The results confirm the need to revise current treatment protocols to incorporate a multidisciplinary strategy with a focus on early rehabilitation.