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Diagnosis of hypertonicity of the masticatory muscles at a dental appointment

https://doi.org/10.36377/1683-2981-2021-19-3-190-199

Abstract

Summary. The purpose of the study. Hypertonus of the masticatory muscles is a fairly common pathology that leads to the development of parafunctional masticatory activity. At the same time, the nature of the course of the pathology becomes long-lasting, leading to irreversible consequences. Patients often do not pay attention to minor pain in the area of the masticatory muscles, so hypertonus of the masticatory muscles is diagnosed randomly. In view of the variety of clinical symptoms from headaches to the phenomena of oral stomalgia, the diagnosis of hypertension is extremely 
difficult. Also, there is currently no single algorithm for the management of such patients.
Materials and methods. In the presented scientific study, a survey of 189 patients who applied to a dental clinic for the treatment of dental caries and its complications, a professional examination was conducted. All patients were examined according to the method of diagnosis of muscle hypertonus developed by us. The methodology includes a thorough collection of anamnesis, questionnaires (PSM-25, VAS, MAS, author's methods), the use of objective research methods, including: OPTG, CT, ultrasound, the author's method of determining the degree of mouth opening.
Results. Muscle hypertonus of varying severity was diagnosed in 80% of cases, high stress level on the PSM-25 scale in 71% (135), the presence of morning pain in the area of the masticatory muscles in 55%(104). An assessment of muscle tone on the MAS scale confirmed a significant increase in masticatory muscle hypertonicity in 34% of cases. These additional methods of investigation confirmed the presence of hypertonicity of the masticatory muscles in patients with an objective clinical picture. In the study of this area, the main role is played by the clinician, only if all the diagnostically valuable information is available, it is possible to formulate an optimal treatment plan and avoid aggravation of the patient's condition due to incorrect diagnosis and treatment.
Conclusions. The application of the developed diagnostic method contributes to the random detection of parafunctional activity of the masticatory muscles at a dental appointment, as well as to the final diagnosis of masticatory muscle hypertonus. 

About the Authors

Yu. A. Makedonova
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Yuliya A. Makedonova, Grand PhD in Medical Sciences, associate professor and head of the Dentistry Department; 
senior researcher at the Innovative methods of rehabilitation and habilitation Laboratory; Volgograd Medical Research Center

Volgograd



A. A. Vorobev
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Aleksandr A. Vorobyov, Grand PhD in Medical Sciences, professor of Operative surgery and topographic anatomy 
Department; professor of the Innovative methods of rehabilitation and habilitation Laboratory

Volgograd



A. N. Osuko
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Anna N. Osyko, assistant of the Dentistry Department

Volgograd



A. V. Alexandrov
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Aleksandr V. Alexandrov, postgraduate of the Dentistry Department

Volgograd



D. Yu. Dyachenko
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Denis Yu. Dyachenko, assistant of the Dentistry Department

Volgograd



A. G. Pavlova-Adamovich
Federal State Budgetary Educational Institution of the Higher Education ”A. I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Anastasiya G. Pavlova-Adamovich, postgraduate of the Dentistry Department

Volgograd



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For citations:


Makedonova Yu.A., Vorobev A.A., Osuko A.N., Alexandrov A.V., Dyachenko D.Yu., Pavlova-Adamovich A.G. Diagnosis of hypertonicity of the masticatory muscles at a dental appointment. Endodontics Today. 2021;19(3):190-199. (In Russ.) https://doi.org/10.36377/1683-2981-2021-19-3-190-199



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