مجله دانشکده دندانپزشکی اصفهان
مروری بر درمان‌های غیرجراحی اختلالات مفصل گیجگاهی‌فکی
نوع مقاله : مقاله‌های مروری
چکیده
مقدمه: بیماری‌های مفصل گیجگاهی- فکی به تحت تأثیر قرار گرفتن این مفصل، عضلات و ساختارهای مرتبط با آن اطلاق می‌شود. این بیماری‌ها شیوع بالایی بالغ بر 34 درصد دارند و بر ابعاد مختلف زندگی بیمار اثرگذار هستند. بیماری‌های مفصل گیجگاهی- فکی چند عاملی هستند و با بیماری‌هایی چون اختلال اضطراب و افسردگی عمده ارتباط دوسویه داند. علائم این بیماری از جمله درد و محدودیت در عملکرد مفصل تأثیر منفی بر ابعاد مختلف زندگی بیماران دارد. هدف این مطالعه، بررسی درمان‌های موجود با تمرکز بر درمان‌های غیرتهاجمی و کم تهاجمی در قالب درمان‌های دارویی و غیردارویی است.
شرح مقاله: درمان‌های دارویی و غیردارویی غیرتهاجمی برای مدیریت علائم بیماری، بر روش‌های تهاجمی اولویت دارند. انتخاب درمان باید بر اساس منشاء علائم، یعنی عضلات جونده و یا مفصل انجام گیرد. روش‌های درمانی بررسی شده در دسته درمان‌های دارویی شامل داروهای ضدالتهابی غیراستروئیدی، بی‌حس کننده‌های موضعی، کورتیکواستروئیدها، شل‌کننده‌های عضلانی، اپیوئیدها، گاباپنتین، گلوکزآمین و تزریق درون‌مفصلی سدیم هیالورونات است. در دسته درمان‌های غیردارویی اثرگذاری اسپلینت‌های اکلوزال، فیزیوتراپی، درمان‌های رفتاری شناختی، طب سوزنی، اولتراسوند، لیزرتراپی کم‌توان، تحریک الکتریکی عصب از راه پوست، آرتروسکوپی و آرتروسنتزیز، پرولوتراپی با دکستروز، تزریق پلاسمای غنی از پلاکت و تزریق پلاسمای غنی از فیبرین بررسی شده است.
نتیجه‌گیری: برنامه‌ریزی طرح درمان باید بر اساس علت‌شناسی بیماری هر شخص انجام گیرد. به نظر می‌رسد استفاده از تلفیقی از درمان‌های موجود در افزایش اثربخشی درمان در مدیریت علائم کمک کننده باشد. تعیین اثربخشی و پروتکل تجویز روش‌های درمانی موجود و نیز مقایسه آن‌ها با یک دیگر نیازمند انجام مطالعات بالینی بیشتر است.
کلید واژه‌ها: بیماری‌های مفصل گیجگاهی- فکی؛ درمان دارویی؛ درمان محافظه‌کارانه؛ روش جراحی کم تهاجمی
عنوان مقاله [English]
A Review of Non-Surgical Treatments for Temporomandibular Joint Disorders
چکیده [English]
Introduction: Temporomandibular joint diseases refer to the involvement of this joint, muscles, and related structures. These diseases have a high prevalence of 34% and affect different aspects of the patient's life. Temporomandibular joint diseases are multifactorial and have a bidirectional relation with anxiety disorder and major depressive disorder. The symptoms of this disease, including pain and limitation in joint function, hurt various aspects of patients' lives. This study aims to review available treatments, focusing on non-invasive and minimally-invasive treatments in the form of pharmacological and non-pharmacological therapies.
Article Description: Non-invasive pharmacological and non-pharmacological treatments are preferred over invasive methods to manage disease symptoms. The choice of treatments should be based on the origin of the symptoms, i.e., masticatory muscles or the joint. The treatment methods reviewed in the pharmacological treatment category include non-steroidal anti-inflammatory drugs, local anesthetics, corticosteroids, muscle relaxants, opioids, gabapentin, glucosamine, and intra-articular injection of sodium hyaluronate. In the category of non-pharmacological treatments, the effectiveness of occlusal splints, physiotherapy, cognitive behavioral therapies, acupuncture, ultrasound, low-power laser therapy, transcutaneous electrical nerve stimulation, arthroscopy, and arthrocentesis, prolotherapy with dextrose, platelet-rich plasma injection, and fibrin-rich plasma injection have been investigated.
Conclusion: Planning the treatment plan should be done based on the etiology of each individual's disease. The use of a combination of available treatments seems to help in increasing the effectiveness of treatment in managing symptoms. Determining the effectiveness and prescription protocol of available treatment methods and comparing them with each other requires more clinical studies.
Keywords: Temporomandibular joint diseases; Drug therapy; Conservative treatment; Minimally-invasive surgical procedure
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