Articulatio temporomandibularis disfonksiyonu olan bireylerde eklem ve çiğneme kaslarının morfometrik analizi ve kuru iğneleme yönteminin etkileri
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Dosyalar
Tarih
2015
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızın amacı articulatio temporomandibularis (ATM) disfonksiyonu olan bireylerde eklem hareketlerindeki etkilenimin, discus articularis-caput mandibulae ilişkisinin ve çiğneme kaslarının boyutlarındaki değişimlerin MRG yöntemi kullanılarak normal bireylerle karşılaştırılması, ayrıca kuru iğneleme ve mobilizasyon ile statik splint yöntemlerinin etkinliğinin araştırılmasıdır. Gereç ve yöntem: Çalışma, ATM disfonksiyonu tanısı konmuş 34 birey (yaş ortalaması 29.44±12.97) ve 17 sağlıklı bireyin (yaş ortalaması 32.82±11.99) Manyetik Rezonans Görüntüleri (MRG) üzerinde gerçekleştirildi. Bireyler kuru iğneleme+mobilizasyon (KM) (n=18;13K-5E) ve stabilizasyon splinti (SS) (n=16;14K-2E) olmak iki gruba ayrılarak tedavi programı uygulandı. Birinci gruba haftada üç gün olmak üzere toplam 10 seans kuru iğneleme ve mobilizasyon uygulanırken, ikinci gruba bir ay süreyle kullanacakları stabilizasyon splinti verildi. Bu iki grubun tedavi öncesi ve sonrasında klinik değerlendirme bulguları ile MRG ölçümleri incelenirken, kontrol grubu olarak arşivden seçilen 17 sağlıklı bireyin (n=17,8K-9E) ATM'sine ait MR görüntüleri üzerinden morfometrik ölçümler yapıldı. Bulgular: ATM disfonksiyonu olan bireylerin %79.4'nün (n=27) kadın, 61.8'inin (n=21) bekar ve %47.1'inin de öğrenci (n=16) olduğu saptandı. Bireylerin %29.4'ünde sol taraf, %26.5'inde sağ taraf ve %44.1'inde ise çift tarafta etkilenim olduğu tespit edildi. KM'de servikal bölge ve mandibula normal eklem hareket açıklıklarında anlamlı artış olduğu (p<0.05), SS'de ise değişim olmadığı görüldü. Ayrıca KM'nin semptomlar, tetik noktalar ve ağrıyı azalttığı, SS'nin semptomlarda azalma sağladığı ancak tetik noktalar ve ağrıda etkisinin olmadığı görüldü. Ağrı, uyku kalitesi ve depresyon arasında anlamlı korelasyon olduğu saptandı. MRG görüntüleri incelendiğinde ATM disfonksiyonlu bireylerin çiğneme kaslarının uzunluk ve genişliklerinin normalden kısa olduğu, caput mandibulae şekillerinde farklılık, fossa mandibularis derinliğinde ise azalma olduğu gözlendi (p<0.05). Discus articularis deplasman miktarının ise KM grubunda azaldığı, SS'de değişmediği tespit edildi. Sonuç: ATM disfonksiyonu olan bireylerde eklem içi yapılar ve çiğneme kaslarının şekil ve boyutlarında etkilenim olduğu saptandı. Kuru iğneleme+mobilizasyon uygulamasının semptomlar, tetik noktalar, eklem hareketliliği ve ağrı üzerinde statik splintten üstün olduğu görüldü.
Objective: The objective of our study is to compare and contrast the influence of the joint movements on patients with Articulatio Temporomandibularis Dysfunction (ATM), the relationship between discus articularis and caput mandibulae and the comparison of the of the changes of the size of Masticatory Muscles with those of normal individuals by using MRI method as well as researching the effectiveness of the methods such as dry needling and mobilisation and static splint. Material and Method: This study has been implemented on the Magnetic Resonance Imaging (MRI) of 34 patients who we diagnosed with ATM Dysfunction (average of age 29.44±12.97) and 17 healthy individuals (age average 32.82±11.99). The treatment programme has been applied by dividing the individuals into two groups; dry needling + mobilisation (KM) (n=18;13K-5E) and stabilisation splint (SS) (n=16;14K-2E). The first group has been given dry needling and mobilisation for 10 sessions over the course of 3 days a week and the second group has been given their stabilisation splints which they were to use for the duration of one month. The clinical evaluation findings and the MRI measurements before and after the treatment for both of the groups have been analysed and morphometric measurements have been made on the MR Images of the ATM of 17 healthy individuals who were randomly selected from the archive as the control group (n=17,8K-9E). Findings: It has been determined that 79.4 of the individuals with ATM Dysfunction are female (n=27), 61.8% are single (n=21) and 47.1 are students (n=16). It has also been observed that 29.4% of the individuals had influence on their left side, 26.5% had influence on the right side and 44.1% had it on both sides. It has also been observed that there has been a significant increase on the cervical area of KM and on the mandibular normal joint range of motion (p<0.05) and no change on the SS. In addition, it has also been observed that the KM reduced the symptoms, trigger points and pain whereas the SS had no effect on the trigger points and on pain although it helped reduce the symptoms. It has been determined that there is a significant correlation between pain, sleep quality and depression. When the MRI images have been examined, it has been observed that the length and width of the masticatory muscles are shorter than normal; differences of shape on caput mandibulae and a decrease of the depth of fossa mandibularis on individuals with ATM Dysfunction (p<0.05). It has been determined that the amount of Discus articularis displacement has decreased on the group with KM but remained unchanged on the group with SS. Conclusion: It has been ascertained that there is an influence on the shape and size of the masticatory muscles and on intra-articular structures. It has also been observed that the dry needling + mobilisation method has proven to be better than static splint with regards to symptoms, trigger points, joint mobility and pain.
Objective: The objective of our study is to compare and contrast the influence of the joint movements on patients with Articulatio Temporomandibularis Dysfunction (ATM), the relationship between discus articularis and caput mandibulae and the comparison of the of the changes of the size of Masticatory Muscles with those of normal individuals by using MRI method as well as researching the effectiveness of the methods such as dry needling and mobilisation and static splint. Material and Method: This study has been implemented on the Magnetic Resonance Imaging (MRI) of 34 patients who we diagnosed with ATM Dysfunction (average of age 29.44±12.97) and 17 healthy individuals (age average 32.82±11.99). The treatment programme has been applied by dividing the individuals into two groups; dry needling + mobilisation (KM) (n=18;13K-5E) and stabilisation splint (SS) (n=16;14K-2E). The first group has been given dry needling and mobilisation for 10 sessions over the course of 3 days a week and the second group has been given their stabilisation splints which they were to use for the duration of one month. The clinical evaluation findings and the MRI measurements before and after the treatment for both of the groups have been analysed and morphometric measurements have been made on the MR Images of the ATM of 17 healthy individuals who were randomly selected from the archive as the control group (n=17,8K-9E). Findings: It has been determined that 79.4 of the individuals with ATM Dysfunction are female (n=27), 61.8% are single (n=21) and 47.1 are students (n=16). It has also been observed that 29.4% of the individuals had influence on their left side, 26.5% had influence on the right side and 44.1% had it on both sides. It has also been observed that there has been a significant increase on the cervical area of KM and on the mandibular normal joint range of motion (p<0.05) and no change on the SS. In addition, it has also been observed that the KM reduced the symptoms, trigger points and pain whereas the SS had no effect on the trigger points and on pain although it helped reduce the symptoms. It has been determined that there is a significant correlation between pain, sleep quality and depression. When the MRI images have been examined, it has been observed that the length and width of the masticatory muscles are shorter than normal; differences of shape on caput mandibulae and a decrease of the depth of fossa mandibularis on individuals with ATM Dysfunction (p<0.05). It has been determined that the amount of Discus articularis displacement has decreased on the group with KM but remained unchanged on the group with SS. Conclusion: It has been ascertained that there is an influence on the shape and size of the masticatory muscles and on intra-articular structures. It has also been observed that the dry needling + mobilisation method has proven to be better than static splint with regards to symptoms, trigger points, joint mobility and pain.
Açıklama
Doktora Tezi
Anahtar Kelimeler
Articulatio Temporomandibularis, MRG, Kuru İğneleme, Statik Splint, Çiğneme Kasları, MRI, Dry Needling, Static Splint, Masticatory Muscles
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Duman, F. (2015). Articulatio temporomandibularis disfonksiyonu olan bireylerde eklem ve çiğneme kaslarının morfometrik analizi ve kuru iğneleme yönteminin etkileri. (Yayımlanmamış doktora tezi). Necmettin Erbakan Üniversitesi, Sağlık Bilimleri Enstitüsü Anatomi Anabilim Dalı, Konya.
