Dental and Medical Problems

Dent Med Probl
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Dental and Medical Problems

2012, vol. 49, nr 3, July-September, p. 427–432

Publication type: review

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Recent Reviews on the Influence of Orthodontic Treatment on the Appearance of Temporo-Mandibular Joints Dysfunction

Aktualne poglądy na temat wpływu leczenia ortodontycznego na występowanie dysfunkcji stawów skroniowo-żuchwowych

Joanna Antoszewska1,A,E, Marlena Kosior1,E,F

1 Department of Orthodontics and Dentofacial Orthopedics, Wroclaw Medical University, Poland

Abstract

The article is a reply to the increasingly frequent attempts to blame orthodontists for causing dysfunction of the temporo-mandibular joints (TMJ) as an iatrogenic consequence of orthodontic treatment. The presented review of literature is not only a careful analysis of orthodontic treatment as a potential risk factor favoring dysfunction. Articles available in the literature also allowed authors to draw conclusions about specific functional appliances and their effect on the abnormal function of the temporo-mandibular joints. As is clear from the papers published in the last decade, there is no scientific evidence supporting any association of either the correction of malocclusions itself, as well as the specific orthodontic technique used in this treatment approach with impaired TMJ function. The thesis quoted after Seligman and Okeson allow orthodontists to solidify the view that the careful treatment of malocclusion, even if it does not lead to an ideal occlusion (in accordance with the gnathologist’s concept), helps to meet the aesthetic requirements of patients. Exposure of the TMJ to dysfunctions – in the absence of the evidence such as meta-analyzes – cannot support the speculation on this very controversial subject, especially in the claim cases.

Streszczenie

Artykuł jest zasadniczo dopowiedzią na coraz częstsze próby oskarżania lekarzy ortodontów o powodowanie dysfunkcji stawów skroniowo-żuchwowych jako jatrogennej konsekwencji leczenia ortodontycznego. Zaprezentowany przegląd piśmiennictwa to nie tylko staranna analiza związku samego leczenia ortodontycznego z potencjalnym ryzykiem rozwoju dysfunkcji. Pozycje dostępnego piśmiennictwa pozwoliły również wyciągnąć wnioski dotyczące konkretnych aparatów czynnościowych i ich wpływu na nieprawidłową czynność stawów skroniowo-żuchwowych. Jak wynika z artykułów opublikowanych w ostatniej dekadzie, a więc najbardziej współczesnych, nie ma dowodów naukowych na jakikolwiek związek zarówno przeprowadzonej korekty zaburzenia zgryzowo-zębowego, jak i techniki, którą w takim leczeniu wykorzystano z zaburzeniem czynności stawu skroniowo-żuchwowego. Wyszczególnione tezy Seligmana i Okesona pozwalają środowisku lekarzy ortodontów ugruntować opinię, że ich staranne leczenie nieprawidłowości zgryzowych, nawet jeśli nie prowadzi do okluzji idealnej (zgodnej z wytycznymi gnatologów), pomaga spełniać wymagania estetyczne pacjentów. Narażanie ich stawów skroniowo-żuchwowych na dysfunkcje – wobec braku dowodów w postaci metaanaliz – nie pozwala wspierać spekulacji na ten tak kontrowersyjny temat, zwłaszcza w przypadkach roszczeniowych.

Key words

orthodontics, temporo-mandibular joints dysfunction, dysfunctions

Słowa kluczowe

leczenie ortodontyczne, stawy skroniowo-żuchwowe, dysfunkcje

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