OPTIMIZATION OF THERAPY FOR PAINFUL DYSFUNCTIONAL SYNDROME OF THE TEMPOROMANDIBULAR JOINT IN PATIENTS WITH MANDIBULAR FRACTURES

Abstract

The aim of this study is to develop and clinically validate an improved therapeutic approach for the management of painful dysfunction of the temporomandibular joint (TMJ) in individuals with mandibular fractures. The relevance of the issue is determined by the high prevalence of traumatic mandibular injuries, which are often accompanied by the development of secondary functional disorders of the TMJ. The painful form of TMJ dysfunction significantly reduces patients’ quality of life, complicates the rehabilitation process, and may lead to the development of chronic pain syndrome and persistent impairment of masticatory function. This study analyzes existing diagnostic and therapeutic approaches to TMJ pain dysfunction and identifies their limitations, which served as the basis for the development of a comprehensive therapeutic and rehabilitation algorithm. The proposed strategy includes gentle immobilization techniques, individualized physiotherapy procedures, myogymnastics, pharmacological support, and, when necessary, minimally invasive interventions. Special attention is given to the early detection of dysfunction using modern instrumental diagnostic methods (including MRI, ultrasound, and electromyography) for accurate assessment of joint structures and masticatory muscles. A clinical trial conducted on a group of patients with various types of mandibular fractures demonstrated that the proposed treatment complex facilitates faster and more stable achievement of positive clinical outcomes. A significant reduction in pain intensity, increased range of joint motion, and improved masticatory function were observed in a shorter period compared to traditional methods. Additionally, improvements in patients' psychoemotional state, reduced anxiety levels, and normalized sleep were recorded.