MODERN METHODS OF TREATMENT OF TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS

Abstract

Relevance. Temporomandibular joint osteoarthritis is a chronic degenerative-inflammatory disease accompanied by pain, limitation of mouth opening, joint noises, impaired masticatory function, and reduced quality of life. The modern approach to the treatment of this pathology is based on stepwise therapy: from conservative methods to minimally invasive intra-articular procedures and surgical treatment in cases of severe structural changes. In recent years, special attention has been paid to the use of hyaluronic acid, platelet-rich plasma, arthrocentesis, arthroscopy, physiotherapy, and comprehensive rehabilitation.

Aim of the study. To analyze modern methods of treatment of temporomandibular joint osteoarthritis and determine their clinical significance in restoring joint function and reducing pain syndrome.

Materials and methods. A review of modern scientific publications, clinical guidelines, and systematic reviews devoted to the treatment of temporomandibular joint osteoarthritis was conducted. Conservative, pharmacological, physiotherapeutic, injection-based, minimally invasive, and surgical treatment methods were analyzed.

Results. The analysis showed that the most rational approach is comprehensive therapy, including elimination of joint overload, occlusal correction, use of stabilization splints, pharmacotherapy, physiotherapy, and therapeutic exercises. If conservative treatment is insufficiently effective, intra-articular injections of hyaluronic acid, corticosteroids, PRP/PRF, as well as arthrocentesis are used. Current data indicate that PRP and PRF may improve pain parameters and maximum mouth opening, especially as an adjunct to arthrocentesis; however, the quality of evidence and standardization of protocols remain limited.

Conclusions. Treatment of temporomandibular joint osteoarthritis should be individualized, stepwise, and interdisciplinary. In the early stages, preference should be given to conservative methods, whereas in cases of severe pain, dysfunction, and degenerative changes, minimally invasive methods may be appropriate. Surgical treatment is indicated only in severe forms of the disease and when previous therapy is ineffective.