Application of botulinic toxin in treatment of an immovable displacement of a joint disk of a temp-jain jaw
Among the pathology of the temporomandibular joint (TMJ), non-guided articular displacement of the articular disc (NSSD) is particularly complex clinical manifestations, the severity of the course and always accompanied by myofascial pain disorders. Objective: to improve treatment outcomes for patients with TMJ and myofascial pain syndromes. Materials and methods. 38 patients were examined and treated with non-guided articular displacement of the TMJ and myofascial pain disorders. Of the additional research methods, CBCT, MRI, EMG were used. Phased treatment was carried out, including drug therapy, injections of botulinum toxin type A (BTA) in the actual chewing, temporal, lateral pterygoid muscles (LMW) bilaterally; reposition splint therapy; arthrocentesis with lavage of both joint spaces. Results. overall treatment efficacy was 97.4%. Of the 38 patients in 34 (89.5%), the treatment was carried out without arthrocentesis with full restoration of the range of motion of the lower jaw and the elimination of pain. Conclusions. An effective system has been developed for a phased integrated treatment of non-guided articular displacement of the articular disc of the TMJ; A new method of periarticular injection access to the coatings has been developed, which allows the administration of drugs into its upper and lower heads. The high efficiency of the use of BTA injections in the treatment of NSPD is due to the mandatory introduction of the drug into 3 muscles: the chewing, temporal and lateral pterygoids. In the treatment of NSPD, arthrocentesis is effective with lavage of the lower and upper articular spaces.