A method of treating pain dysfunction and inflammatory and degenerative diseases of the temporomandibular joint

 

(57) Abstract:

The invention relates to medicine, and is intended for the treatment of pain disorders and inflammatory and degenerative diseases of the temporomandibular joint. Conduct the electrical stimulation pulse modulated current to the area of the temporomandibular joint, masticatory muscles, muscles of the neck. Additionally affect digastric muscle submandibular region, the trapezius muscle in the interscapular region, and the impact on the latter alternating with the impact on the sternocleidomastoid muscle, the stimulation perform low-frequency pulsed current, with asymmetric bipolar pulse shape with a trapezoidal envelope, amperage, which pick up on the feeling of the patient, changing the course from a light vibration to the muscle contraction. Simultaneously affected in the projection of the temporomandibular joints in front of the tragus and andorlini, with a frequency of 100 to 150 Hz with a continuous form of the parcels, the amperage it should be determined on an individual feel a light vibration, the exposure time is gradually increased from 5 to 20 minutes on the course. The course is 14-15 daily procedures. The method improves the efficiency is CLASS="ptx2">

The invention relates to medicine, in particular to physiotherapy, and relates to a method of treatment of patients with painful dysfunction of the temporomandibular joint, such as arthritis and osteoarthritis, including after injury or surgery in the maxillofacial region.

There is a method of exposure percutaneous electrical nerve stimulation on the projection of niiniluoto joint (TMJ) pain syndrome (A. J. Vyaz'min, Y. M. Podkorytov. The use of transcutaneous electroneurostimulation in the treatment of dysfunction of the temporomandibular joint. "Problems of neurosonology and dentistry", 1998, 2, S. 53-54), which use impact on the field of TMJ skin and ear canal.

The disadvantage of this method is that the effect only in the area of TMJ without regard to the muscular component of pain and lack of analgesic effect of percutaneous electrical nerve stimulation, which requires the implementation of procedures several times a day.

There is a method of applying electrical stimulation (L. P. Gerasimov. Application software multichannel bioelectric control in rehabilitation of children with congenital and acquired defects of the maxillofacial areas of the hyoid muscles rectangular current frequency of 40 Hz from the "Myton-3M. The disadvantage of this method is the modulation current according to individual electromyograms (EMG), and it is known that EMG changes in all muscle groups in different ways depending on the duration and severity of the pathological process, so the patient is imposed modulation, which may not correspond to individual norm. In addition, when the appearance of painful dysfunction and TMJ arthrosis in the pathological process involved not only the chewing muscles, but also a number of related muscles, as evidenced by the radiation of pain and the presence of trigger points in muscles, genetically related and originate from the same visceral arc - mandibular.

The closest is a method of treating pain dysfunction and inflammatory and degenerative diseases of the temporomandibular joint, including the stimulation pulse modulated current to the area of the temporomandibular joint, masticatory muscles, neck muscles (E. N. Silantyev. To the question of rehabilitation of patients with myofascial pain dysfunction syndrome maxillofacial area with clinically significant cervical osteochondrosis. 1 materials of the Russian scientific forum "Technologies of restorative medicinelodge modulated current (SMC-therapy) TMJ. Remission was $ 70.7-85,8%.

The disadvantage of this technique is that it does not take into account chewing muscles groups involved in the pathological process. In addition, in children and adolescents with immature bone skeleton exposure to ultrasound is contraindicated in the growth zone of the lower jaw. Ultrasound therapy is also limited in patients with diabetes, which is often found in this group. The technique is laborious and time-consuming.

The problem posed by the authors, is to eliminate these drawbacks by developing techniques to reduce the treatment time while achieving a high effect in patients with pain disorders and inflammatory and degenerative diseases of the temporomandibular joint by relieving pain and reducing the activity of trigger points, eliminating functional redistribution of muscle activity of the muscles of the masticatory and neck muscles, improve blood circulation in the maxillofacial area and neck, the normalization of emotional status.

For this purpose, the method of treatment of pain disorders and inflammatory and degenerative diseases of the temporomandibular su is tava, masticatory muscles, neck muscles, proposed to affect the digastric muscle submandibular region, the trapezius muscle in the interscapular region and the effects on the latter to rotate with the impact on the sternocleidomastoid muscle. The stimulation should be carried out low-frequency pulsed current, with asymmetric bipolar pulse shape with a trapezoidal envelope at frequency, preferably selected in the range of 1 -150 Hz, with a period of 2-4, amperage of 0.1-20 mA, focusing on the sensations of the patient, changing them during treatment from a light vibration to the muscle contraction. At the same time to act in the projection of the temporomandibular joints in front of the tragus and andorlini with a frequency of, for example, 100-150 Hz continuous form of the parcels, the amperage it should be determined on an individual feel a light vibration, the exposure time gradually increase from 5 to 20 minutes, at a rate of 14-15 daily procedures.

The method is as follows.

Multichannel electrical stimulation is low-frequency pulsed current, with asymmetric bipolar pulse shape with a trapezoidal envelope with a frequency of from 1 to 150 Hz, with periodname, the exposure time increases gradually in the course of from 5 to 20 minutes.

Specific type of pacemaker corresponding to the above parameters may be different, however, for practical and professional work in the most effective and proved to be reliable microprocessor-based multichannel stimulator type "Mymodel". As the electrodes are the most useful application of adhesive electrodes up to 20, from 12 cm to 162 cm, depending on the zone of influence. A pair of electrodes are superimposed on cutaneous muscle perpendicular to the direction of muscle fibers.

Area of exposure: skin projection of the temporal, masseter, digastric muscles daily from two sides, and sternocleidomastoid muscles, alternating every other day with the trapezius muscle. The electrodes are connected respectively to the channels of the device (1-8 channels), current pick individual feelings of the patient to light good vibrations (early treatment) and muscle contraction (end of treatment). The channels operate in the mode of electrical stimulation on the above parameters.

Additionally, to restore the function of the TMJ and relieving pain 9-10 channels worked in R is. The electrodes were placed in the ear canal and in the projection of the TMJ in front of the tragus of the ear.

Control methods for treatment were: methods of algometry by A. P. the Zilber (D. P. silber. Clinical physiology in intensive care and anesthesia. - M. 1984), the amount of locomotor function, neuromuscular diagnosis, electromyography, rheography, ECG, x-ray, biochemical blood tests.

Just treated 27 people with painful TMJ dysfunction (mild, moderate, severe severity), 7 people with osteoarthritis of the TMJ, 12 with pain syndromes after fractures of the lower jaw.

Clinical and functional studies have revealed the relief of pain, restoration of movements of the lower jaw, no additional noise in the area of TMJ; also normalized microcirculation in the muscles, which was conducted impact indicators elektrovojvodina and electromyography in 89.5% of patients. When severe pain of TMJ in the background of osteoarthritis significant relief of pain and normalization of functional activity of masticatory muscles, but remains a clicking noise in the TMJ and the residual disturbance of microcirculation in the muscles of jaw-liie year.

Example 1.

Patient K., 1968 R., and b/W 1437 was admitted with a diagnosis of Painful dysfunction of the temporomandibular joint moderate. Trism P. Art. Ill for about 2 years, repeatedly received medical therapy, attended iodine electrophoresis, phonophoresis of hydrocortisone, clinical efficacy was maintained for 4-6 months. Took indomethacin on 1 tab. 4 times a day. Pain was not relieved.

Objectively movement in TMJ limited, palpation of the painful joint. His mouth opens to 2 cm, there is a pronounced stress masseter, temporal muscle, sternocleidomastoid muscle. Pain at the points of exit of the trigeminal nerve is not defined. Loss of sensitivity is not observed. There is a trigger point in the chewing muscles on the right and the temporal muscle on the left. Zigzag mouth opening.

The appointed course of multichannel electrical stimulation apparatus of Mymodel". Pairs of electrodes were applied cutaneous perpendicular to the direction of muscle fibers of the temporal, masseter, digastric muscles on both sides, and sternocleidomastoid muscles every other day, alternating with the trapezius muscle. The electrodes are connected respectively to the channels of the device is s) and muscle contraction (4-14 procedure).

The channels were working in the mode of electrical stimulation at a frequency of from 20 to 120 Hz, with a period of 4 seconds and amperage from 0.1 to 20 mA.

Additional electrodes were placed in the ear canal and in the projection of the TMJ in front of the tragus of the ear (9-10 channels), with a frequency of 100 to 150 Hz with a continuous form of parcels at current strength until you feel a light vibration. Course 14 procedures carried out daily, the exposure time is gradually increased in the course of from 5 to 20 minutes, adding on each procedure 1 minute.

The third procedure pain significantly decreased for the fifth procedure is cancelled indomethacin. At the end of treatment pain syndrome of the patient is not bothered, mouth opening free 3 cm, palpation of the joint painless. Clinical effect was observed up to 1 year (observation period).

Example 2.

Patient A. , 1938, R. , and b/W 1572. Diagnosis: Pain TMJ dysfunction moderate severity. Coronary artery disease; angina F. CL.2 NGOs. Hypertension II B stage. History after double fracture of the mandible, the patient was siniawan individual wire bus. Three months later, after removing the tire remained limited mouth opening, up to 1.5 cm, zigzag mouth opening, pain syndrome. Boolavogue syndrome was not, mouth opening to 2 see, There are trigger points in the area of digastric muscle, sternocleidomastoid muscle on the right masseter left. The exit point of the trigeminal nerve painless to palpation.

Raising HELL to 170/100 mm RT. Art., recurrent pain in the heart, aggravated by severe physical and emotional stress and intractable nitroglycerin. With coronary artery disease for 7 years, angina voltage occur 2-3 times per month, mostly after exercise, take place after administration of nitroglycerin. Treated as an outpatient beta-blockers. HELL varies 150/95 - 170/100 mm RT. senior Patient arrived at the sanatorium-resort treatment for 12 days.

Due to CHD and hypertension continued treatment with beta-blockers.

The appointed course of multichannel electrical stimulation apparatus of Mymodel" with the aforementioned method in example 1.

Portability procedures good, exacerbation of pain in the course of treatment were observed. Under the influence of the treatment was stopped pain, increased range of motion, mouth opening to 3.5 see angina, arrhythmias, dyspnea were noted. HELL stable the th wall of the left ventricle.

When re-entering after 6 months marked by persistent clinical effect, which was not allowed to take non-steroidal anti-inflammatory drugs, pain is not expressed.

The advantage of the proposed method is to improve the functional state of the neuromuscular apparatus of the maxillofacial area, the relief of pain and reduction of treatment time up to 10-12 days to increase its efficiency up to 89.5% at the expense of differentiated and integrated approach to the effects on the basic pathogenesis of the pain of TMJ.

A method of treating pain dysfunction and inflammatory and degenerative diseases of the temporomandibular joint, including the stimulation pulse modulated current to the area of the temporomandibular joint, masticatory muscles, muscles of the neck, characterized in that it further affect the digastric muscle submandibular region, the trapezius muscle in the interscapular region, and the impact on the latter alternating with the impact on the sternocleidomastoid muscle, the stimulation perform low-frequency pulsed current, with asymmetric bipolar pulse shape with trapezoid is falling muscles, at the same time act in the projection of the temporomandibular joints in front of the tragus and andorlini, with a frequency of 100 to 150 Hz with a continuous form of the parcels, the amperage it should be determined on an individual feel a light vibration, the exposure time is gradually increased from 5 to 20 min on the course, the course is 14-15 daily procedures.

 

Same patents:

The invention relates to medicine, arthrology and can be used for the treatment of polyesterwith
The invention relates to medicine, and is intended for the treatment of chronic bronchopulmonary process in children with the syndrome SV-Addition

The invention relates to medicine, arthrology and can be used for the treatment of polyesterwith

The invention relates to biomedical engineering, more specifically to electro-stimulation devices for the diagnosis and treatment of organs and tissues

The invention relates to the field of biomedical engineering, more specifically to electro-stimulation devices for the diagnosis and treatment of organs and tissues

The invention relates to medicine, physiotherapy and can be used for the treatment of uretroprostatit

The invention relates to medicine, and is intended for the treatment of children with functional cardiopathy

The invention relates to medicine, and is intended for the treatment of children with functional cardiopathy from areas with radionuclide contamination
The invention relates to medicine, namely to obstetrics, and can be used for doing the first half of pregnancy induced

The invention relates to medical equipment, namely to physical therapy devices, and can be used to treat pathologies local hyperthermia (sciatica, bursitis, myositis)

FIELD: medical engineering.

SUBSTANCE: device has programmable unit for producing output impulses having analog-to-digital signal converter connected to radio frequency communication unit having external programming and feeding unit and connected to wire electrode for supplying stimulation impulses to organs and tissues and biosensor units of respiratory and cardiovascular system parameters and autonomous power supply source. Electrostimulator envelope is manufactured from porous biologically inert silicon material containing carbon biosensors in the pores.

EFFECT: enhanced effectiveness of stimulation; long service life; operation safety.

4 dwg

FIELD: medical engineering.

SUBSTANCE: device has programmable unit for producing output impulses having analog-to-digital signal converter connected to radio frequency communication unit having external programming and feeding unit and connected to wire electrode for supplying stimulation impulses to organs and tissues and biosensor units of respiratory and cardiovascular system parameters and autonomous power supply source. Electrostimulator envelope is manufactured from porous biologically inert silicon material containing carbon biosensors in the pores.

EFFECT: enhanced effectiveness of stimulation; long service life; operation safety.

4 dwg

FIELD: medicine; cosmetics; medical engineering.

SUBSTANCE: device has DC power supply source, unit for controlling and producing starting pulses, demultiplexor unit, two-sectioned, inductance coil of high figure of merit, key amplifiers and electrode unit having coaxial active and passive electrodes. The electrode unit has electric insulating casing and external passive electrode and internal active electrode coaxially mounted on end and/or lateral casing surface. The electrodes are connected to stimulator device output via outgoing wire leads. The casing is designed as hollow truncated tetrahedral pyramid. Contact surfaces of the electrodes have revolution body surface which radius is 3-10 or more times as large as maximum external electrode size. Method involves applying the stimulator device by smoothly moving or changing place of the electrode unit having coaxial active and passive electrodes along massage lines of face and/or neck. The electrodes are connected to the inductance coil of high figure of merit (greater than 100) periodically saturated with electromagnetic energy in connecting several coil loops to DC power supply source poles for given time of 0.5-500 mcs having 1.0-12.0 V voltage. Repeated connection is carried out not earlier than in twice the connection time duration. The first electric oscillation half-wave amplitude is equal to A=20-800 V and oscillation period T=0.1-200 mcs. Treatment with electric current is administered at least every second day during 21-25 days with total treatment time being 10-40 min per day.

EFFECT: enhanced effectiveness of treatment; high stability of contact to skin; accelerated treatment course.

21 cl, 11 dwg

FIELD: medicine.

SUBSTANCE: method involves using Stimul-1 apparatus. Movements applied in manual muscular testing are administered concurrently with current passed through. Initial postures are selected with injured muscle force, measured as a result of manual muscular test, taken into account. 4 points estimation being obtained, movement in articulation is carried out with gravitation force and weighting collar load of 500 g being overcome in standing sitting and lying position. 3 points high estimation being the case, movements are carried out without gravitation force being overcome in sitting position to train lower extremity articulations. 2 points high estimation being obtained, movements are carried out under easier conditions without gravitation force loading in lying initial position. 1 point being the estimation, patient strains muscle in isometric mode in lying initial position.

EFFECT: enhanced effectiveness of rehabilitation treatment; involving earlier idle muscle fibers in work.

FIELD: medicine.

SUBSTANCE: method involves setting electrode on epicardial surface of the right ventricle in making operation. Programmed right ventricle electrostimulation is carried out by means of the electrode. Superficial electrocardiogram is continuously recorded in process of stimulation. Ectopic ventricular activity being observed during electrostimulation, potential ventricular arrhythmia occurrence is predicted in postoperative period.

EFFECT: high reliability of prognosis with no arrhythmia indications in anamnesis.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves exposing motor activity points of injured dorsal muscles to pulsating extremely high frequency noise radiation in bandwidth of 52-78 GHz, duration of 1 mcs, mean power flow intensity of 0.85 mcW/cm2. Their tonus is to be determined in advance. Tonus being initially high, the daily treatment session is 5-8 min long. Tonus being initially low, the daily treatment session is 2-4 min long. The total treatment course is 8-15 procedures long.

EFFECT: enhanced effectiveness of treatment; reduced pain feeling intensity; stable treatment effect.

1 dwg, 7 tbl

FIELD: medicine.

SUBSTANCE: method involves applying thermomagnetic self-excitation inductance treatment of 1.2-2 Tesla units in subcortical nuclei projection with effective frequencies detected from increased amplitude of somatosensory and motor invoked potential and dophamine level growth in blood or liquor, reduced basic rhythm disorganization on electroencephalogram before and after applying thermomagnetic self-excitation inductance treatment. Synchronized median nerve electrostimulation with rectangular pulses is concurrently carried out with current intensity equal to 12-18 A and pulse duration of 0.1-0.l3 ms in trains of 3-5 s duration and 6-10 s long pauses with pulse succession frequency equal to 50 Hz daily during 15-30 min. The total treatment course is 10-20 days long.

EFFECT: enhanced effectiveness of treatment.

Electrode device // 2252793

FIELD: medical equipment.

SUBSTANCE: device can be used in multichannel in electrical neuron-adaptive stimulators. Electrode device has joint for connecting multichannel neuron-adaptive stimulator and flat multiwired flexible cable. Each wire of cable is connected with corresponding contact of joint for switching stimulator in. Mounting shoes provided with fixing bushings are installed along the whole length of flexible cable. Electrodes are inserted into fixing bushings. Each contact of mounting shoe is connected with corresponding contact of joint via wire of flat multiwired flexible cable. Fixing metal bushing is connected contact of mounting shoe through conductor. Connection is made in such a way that number of contact corresponds to number of mounting shoe, to number of wire of multiwired flexible cable and to number of contact of joint.

EFFECT: improved efficiency of electro-therapeutic influence when treating prolonged pathological areas.

2 dwg

FIELD: medicine; medical engineering.

SUBSTANCE: method involves placing negative and positive electrode on skin surface in the innervation area of the second and the third trigeminus branch. An additional negative electrode is applied in the innervation area of auriculotemporal trigeminus branch. The electrodes are fed with pulsating electric current in predefined sequence. Current intensity is controlled in stimulation process in a way that patient feels intensive sensation with no pain. Device has DC supply source connected to unit for generating pulsating electric current having three outlet leads for connecting electrodes, modulator having regulator unit, transformer, switch and microprocessor.

EFFECT: enhanced effectiveness of anesthesia in treating teeth.

15 cl, 7 dwg

FIELD: medicine, therapy, cardiology.

SUBSTANCE: at hypertension I stage a patient should be prescribed several courses of transcranial electrostimulation at interval of 1-2 mo per 5-7 seanses , current power being 0.5-0.8 mA. At hypertension II and III stages one should prescribe transcranial eletrostimulation along medicinal therapy, and, also, several courses at interval of 2-3 mo and current power being 0.8-1.2 mA. The innovation enables to remove side effects, shorten the period of in-patient therapy and reduce the dosage of hypotensive preparation.

EFFECT: higher efficiency of therapy.

2 cl, 2 ex, 4 tbl

Up!