Physical Examination of Patients with Diseases of the Temporomandibular Joint

The article deals with the physical examination of patients with temporomandibular joint disease. Temporomandibular joint is a single articulation of the skull, a complex, combined, incongruous joint of the condyle articulation type. The patient with temporomandibular joint dysfunction is examined in order to detect the disease cause, defines the disease development, a character of the morphological and functional impairment, caused by this disease as well as to establish the diagnosis, chooses the treatment method and manages the preventive treatment. Poor examination of the patient and incorrect data analysis instead of recovery will cause progress of the temporomandibular joint pathology, despite satisfactory or good treatment outcome. Physical diagnostics is a complex of medical measures, performed by physician for diagnosing the patient. All the procedures, which refer to this examination, are conducted by the physician (inspection, palpation, auscultation, percussion, etc.). The purpose of the study is actualization of the physical examination of the patients with temporal-mandibular pathologies. Material and methods. 133 patients (84 women and 39 men) aged 19-47 years with temporomandibular pathologies were examined by the Prosthetic dentistry department of O. Bogomolets National Medical University. The authors have analyzed and improved the sequence of physical examination of the patients with temporomandibular pathology, paying attention to some aspects of physical examination of these patients. Results and discussion. The result of the study of patients with temporomandibular pathologies proved that it is necessary to pay attention to the position the patient assumes, the position of his head, cervical and thoracic vertebral department and position of upper extremities. The physician must define how pain intensity differs according to the body position change. It is necessary to estimate the symmetry of functioning of the mimic and chewing muscles, position of lower jaw and shift of the chin related to the nose at rest and when the patient is opening the mouth. The dentist must check whether the patient supports his jaw at rest, feels discomfort during speaking, with partial or complete mouth opening, when signing or brushing his teeth; whether he closes his teeth or if there is a gap between the teeth. It is also necessary to pay attention to probable hypoplasia of the mandible, crossbite or overbite, hypertrophic masticatory muscles, position and movement of the tongue. The dentist must estimate whether the patient bites his tongue, its position at rest and during swallowing. The dentist should additionally perform debridement of the teeth and evaluate the gums and oral mucosa condition. When questioning the patient, the dentist pays attention to the character, intensity, localization and duration of pain, its possible radiation into the head, face or upper extremities.