The incidence of temporomandibular joint dysfunction in women reaches 80% of the total number of patients. The symptoms of temporomandibular joint dysfunction are varied and were first described by otorhinolaryngologist J.B. Costen. In his honor, the entire symptom complex of this disease is named "Costen's syndrome" in specialized literature and in the International Classification of Diseases of the tenth revision. The symptom complex includes joint pain, sometimes radiating to the neck, back of the head, temple, ear, clicks in the joint during movements of the lower jaw, trismus, hearing loss, dull pain in the middle and outside the ear, pain and burning sensation of the tongue, dry mouth; dizziness, pain on the side of the affected joint and even facial pains like trigeminal neuralgia. It is clinically difficult to isolate all these symptoms in patients with dysfunction of the temporomandibular joint, because its pathogenic and etiological manifestation is characterized in most cases only by one or several symptoms.
Temporomandibular joint dysfunction is polyetiological, has a varied clinical picture and is directly dependent on the hormonal state, and especially the gynecological status. Much attention is drawn to the study of estrogen, which, in addition to regulating the functioning of the reproductive system in a woman's body, also performs a number of other important functions, including helping the joint to remain healthy - preventing calcium leaching, stimulating collagen recovery and the work of osteoblasts.
The aim of the study was to determine the frequency of temporomandibular joint dysfunction in women along with hormonal changes and to trace their correlation.
Materials and methods. The study involved 169 students of the third year at the Department of Propedeutics of Surgical Dentistry of the Faculty of Dentistry of the Ukrainian Medical Stomatological Academy. The research methods were based on conducting an anonymous survey. The questions were written for both men and women and were characterized by general dental status. Questions on gynecological status were asked separately for women.
Results and discussion. The study group consisted of 169 people, including 89 women and 80 men aged 18 to 28 years. 61% of men and 26% of women did not have complicated dental status, among those surveyed. At the same time, 35% of men (of their total number) and 28% of women (of their total number) had orthodontic pathology. The presence of individual symptoms of temporomandibular joint dysfunction in men was observed in 6% of the total number of patients, in women - 19% (4% of them had already consulted a dentist, but did not receive adequate treatment). It is worth noting that patients with suspected temporomandibular joint pathology complained only of clicks when opening their mouths or chewing.
Among 89 women studied, 8% had temporomandibular joint dysfunction, but did not have pathologies of the reproductive system. In 20% of women who did not have temporomandibular joint dysfunction, pathology of the reproductive system was noted. 11% had temporomandibular joint dysfunction and pathology of the reproductive system. 26% of women were clinically healthy.
Out of 10 women with temporomandibular joint dysfunction who had a pathology of the reproductive system, but never had problems with the dentition, 10% of the women in the group (1% of all women examined) suffered from menstrual irregularities and had human papillomavirus in their anamnesis. 20% had a suspicion of temporomandibular joint pathology along with problems in their gynecological status and a history of orthodontic treatment, 10% had menstrual irregularities (algodismenorrhea) and were treated by a gynecologist with hormonal contraceptives for up to 1.5 years. 30% of women had temporomandibular joint pathology with problems in their gynecological status and previous therapeutic treatment (presence of fillings in the oral cavity). Of these, 20% have menstrual irregularities, and 10% have cervical erosion. 40% of the total number of women had temporomandibular joint pathology with orthodontic treatment in the past and fillings in the oral cavity along with problems in their gynecological status, where all had menstrual irregularities. 10% of them had metaplasia, erosion of the cervix and uterine polyp, 10% - erosion of the cervix.
It should be noted that out of 89 women, 14 (17.5%) did not have any complaints about the condition of the joint, but had fillings and orthodontic treatment in the past, as well as pathology of the reproductive system. 11 of them (14%) had menstrual irregularities. In 3 (4%) patients out of the total number of women, there was an increased level of androgens, progesterone, estradiol and a history of treatment by a gynecologist.
Based on the results obtained, it is possible to confirm the forced frequency of women visiting the dentist. Among the total number of women with temporomandibular joint dysfunction and pathology of the reproductive system, there was only 1 patient out of 89 persons without any dental interventions in the past. This does not give us a reason to associate gynecological status with the etiology of temporomandibular joint dysfunction. But in view of the greater prevalence of temporomandibular joint dysfunction along with gynecological pathologies, it gives us a basis for active further research on this topic.
Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction
