Title Funkcija stomatognatog sustava u bolesnika s multiplom sklerozom : doktorska disertacija
Author Zoran Kovač
Mentor Ivone Uhač (mentor)
Mentor Juraj Sepčić (mentor)
Committee member Melita Valentić-Peruzović (predsjednik povjerenstva)
Committee member Smiljana Ristić (član povjerenstva)
Committee member Ante Jurjević (član povjerenstva)
Committee member Ivone Uhač (član povjerenstva)
Committee member Juraj Sepčić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine Rijeka
Defense date and country 2006-01-01, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Dental Medicine
Universal decimal classification (UDC ) 616.31 - Stomatology
Abstract Cilj istraživanja: Utvrditi funkcijsku sposobnost stomatognatnog sistema u bolesnika sa multiplom sklerozom (MS); Utvrditi pojavnost simptoma i znakova temporomandibularne disfunkcije (TMD) u MS bolesnika; Utvrditi oblik i intenzitet klinički određene disfunkcije stomatognatog sistema; Procijeniti povezanost intenziteta TMD i tijeka MS.
Ispitanici i postupci: U istraživanju je sudjelovalo 50 MS bolesnika sa područja Primorsko-goranske i Istarske županije koji su tijekom svoje bolesti jednom ili u više navrata liječeni na Klinici za neurologiju - centra i Medicinskog fakulteta u Rijeci, Rijeka.
Ispitivana skupina sastojala se od 14 muškaraca i 36 žena starosne dobi od 20 do 75 godina.
Svi su bolesnici udovoljavali kriterije za klinički sigurnu i laboratorijski potkrijepljenu sigurnu MS prema C.M. Poseru.
U analizi funkcije stomatognatog sistema koristili su se originalno izrađen anamnestički i klinički upitnik. Anamnestički upitnik sastojao se od specifičnih pitanja o subjektivnom doživljaju boli orofacijalne regije, pojave zvukova u temporomandibularnim zglobovima (TMZ), i smetnji u funkciji i ostalih pitanja vezanih uz moguću etiologiju TMD-a. Kliničko ispitivanje uključivalo je procjenu stanja okluzije, žvačnih zglobova, i funkcijske aktivnosti stomatognatog sistema.
Rezultati: Simptomi TMD bili su statistički značajno zastupljeniji u MS bolesnika nego u kontrolnoj skupini. Okluzijske varijable između ispitivanih skupina pokazivale su statističku neznačajnost osim u broju zubi (MS 24,80±3,76; kontrolna skupina 26,48±2,65 ; p <.05). Prosječne vrijednosti svih kretnji bile su značajno manje u MS bolesnika u odnosu na kontrolu (p <.05).
Najzatupljenije dijagnoze prema RDC/TMD protokolu bile su: miofascijalna bol (MS 32%; 2% kontrola grupa; p<.05), pomak diska desno (12% MS bolesnika; 6% kontrole; p>.05), pomak diska lijevo (12% MS bolesnika; 4% kontrole; p>.05), te poremećaji skupine III (artralgija, artritis, artroza) (14% MS bolesnika desno (p=.023) i 16% lijevo (p=.012), a u 0% kontrole; p<.05).
Procjena psihološkog statusa ispitanika pokazala je da 42% MS bolesnika imalo umjerenu i visoku depresiju, 52% umjerene i visoke rezultate nespecifičnih fizikalnih simptoma i 38% III i IV stupanj stupnjevane kronične boli. U odnosu na kontrolnu skupinu gdje su svi rezultati bili znatno niži postojala je razlika u svim varijablama.
Rezultati ovog istraživanja pokazali su veliku pojavnost simptoma TMD-e u MS bolesnika u odnosu na kontrolnu skupinu. Najčešći simptom TMD je bol koji se u MS bolesnika javlja češće i intenzivnije nego u kontrolnoj skupini. Iznosi graničnih kretnji mandibule na smanjenu funkcijsku sposobnost stomatognatog sustava u MS bolesnika. Mišićne disfunkcije su oblik TMD u MS bolesnika, te su značajno češće no u kontrolne skupine. Ovo istraživanje potvrdilo je tezu da MS možemo smatrati predisponirajućim čimbenikom za nastanak temporomandibularne disfunkcije.
Abstract (english) Objectives: Determine the function ability of stomatognatic system in patients with multiple sclerosis (MS); Determine the symptoms and signs occurrence of tempomandibular dysfunction (TMD); Determine the form and intensity of clinically determined stomatognatic system disfunction; Evaluate the TMD intensity and MS course connection.
Patients and Methods: 50 MS patients took part in the research from the Primorsko-goranska and Istra region that have been treated during their illness at the Neurology clinic of the Clinical centre and Medical school at the University of Rijeka, in Rijeka.
The research group was formed out of 14 men and 36 women aged between 20 and 75. All the patients met the diagnostic criteria for clinically and laboratory followed MS determination according to C.M. Poser.
At the stomatognatic system function analysis we have used originally made anamnesis and clinical questionnaire. Anamnesis questionnaire comprised of specific questions on subjective pain experience in the orofacial region, appearance of sounds in temporomandibular joints
(TMJ), function limitations and disturbance and other issues referring to possible aetiology of TMD. Clinical research included occlusion, jaw joints and masticating muscles state evaluation, as well as stomatognatic system function activity.
Results: TMD symptoms were statistically significantly present in MS patients than in the control group. Occlusion variables among the groups under research showed statistical insignificance in the teeth count (MS 24,80+/-3,76; control group26,48+/-2,65; p<.05). Average amounts of ali limited movements were significantly fewer in MS patients related to the control (p<.05).
The most present diagnosis according to RDC/TMD protocol were: myofacial pain (MS 32%; 2% control group; p<.05), disc shift to the right (12% at MS patients; 6% at control; p>.05), disk shift to the left (12% at MS patients, 4% at control; p>.05), and disorders of the IIl group (arthralgiae, arthritis, arthrosis) (14% MS patients to the right (p=.023) and 16% to the left (p=.012) and at 0% control; p<.05).
Subjects psychological status has shown that 42% of Ms patients had moderate and elevated depression, 52% moderate and elevated results of non-specific physical symptoms and 38% chronicle pain of the degree III and IV. Related to the control group where ali the results have been significantly lower, there was statisticaliy significant difference in ali the variables.
Conclusions: This research results showed a great occurrence of TMD symptoms in MS patients related to the control group. The most common symptom of TMD is pain that occurs more often and more intensely than in the control group. The amount of mandibular movement limitations lead to the diminished functional capability of stomatognatic system in
MS patients. Muscular dysfunction are the most common form of TMD in MS patients and are significantly more frequent than in the control group. This research confirmed the thesis how MS can be considered as the predisposing factor in tempomandibular dysfunction making.
Keywords
Multipla skleroza
Temporomandibularna disfunkcija
Orofacijalna bol
RDC/TMD
Keywords (english)
Multiple sclerosis
Tempomadibular dysfunction
Orofacial pain
RDC/TMD
Language croatian
URN:NBN urn:nbn:hr:188:125377
Promotion 2006-03-29
Study programme Title: Biomedicine Postgraduate (doctoral) study programme Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Catalog URL http://www.svkri.uniri.hr/DUFOVI_files/DUF-624.pdf
Type of resource Text
Extent 137 str; 30 cm
File origin Reformatted digital
Access conditions Closed access
Terms of use
Created on 2017-01-19 19:09:31