Evaluation of the effectiveness and satisfaction of patients in the treatment of pain dysfunction of the temporomandibular joint, taking into account the peculiarities of the personality and compliance
Northwestern State University. I.I. Mechnikov, St. Petersburg
Military Medical Academy. C.M. Kirova, St. Petersburg
The work is devoted to the actual problem of dentistry — the treatment of pain dysfunction of the temporomandibular joint (TMJ), the occurrence of which among the adult population is increasing in Russia and abroad. The purpose of the study was to assess the effectiveness and satisfaction of patients with the treatment of pain dysfunction of the TMJ, taking into account the characteristics of the typological orientation of higher nervous activity and compliance. Using semi-quantitative methods, methods of assessing personal response to the disease, known as “Psychosensory-anatomical-functional maladaptation syndrome” (SPSAF), patient satisfaction and compliance, the effectiveness of treatment of TMJ pain dysfunction in 57 men aged 25 to 42 years, with taking into account their temperament. In group 1 (sanguine persons) included 19 people; in 2 (choleric) — 15 people; 3 (phlegmatic) — 11 people; in 4 (melancholic) — 12 people. It was established that before treatment, patients with pain dysfunction of the TMJ had a state of disadaptation. After the patients underwent a complex of dental treatment and preventive measures recommended by dentists, there was a positive trend in the personal response to the disease and, in conclusion of the dynamic observation of the patients, they were adapted to the conditions of existence. A positive change in the internal picture of the disease affected the patient satisfaction with treatment. Patients of groups 1 and 3 were generally satisfied with the results of treatment, which corresponded to the data obtained in evaluating the effectiveness of the treatment and preventive measures taken (40.91% and 64.1%, respectively). Patients of groups 2 and 4 of the study, despite the high clinical efficacy of treating TMJ pain dysfunction (32.18% and 19.7%, respectively), were less satisfied with the results of treatment due to the typological features of their higher nervous activity that play not the last role in ensuring compliance. The most committed to the implementation of medical recommendations were patients of 3 groups who performed them regularly and in full. Patients of groups 1, 2 and 4 carried out the recommendations of the dentist partially, from 25% to 50%. Despite the knowledge of medical recommendations, the possibility of negative consequences for non-compliance, most patients did not have adequate commitment to perform medical prescriptions, did not voluntarily fully follow the prescribed treatment regimen and behavior. Taking into account the findings, it was suggested to pay more attention to the somatopsychic approach in diagnosing and treating various diseases, including organs and tissues of the masticatory apparatus, taking into account the personal response to the disease, typological orientation of higher nervous activity and other factors that take into account the individual characteristics of the patient.
Keywords: pain dysfunction, temporomandibular joint, personal response to the disease, internal picture of the disease, compliance with treatment, satisfaction with treatment, treatment effectiveness, temperament, dental rehabilitation.
For citation: Iordanishvili A.K. Evaluation of the effectiveness and satisfaction of patients in the treatment of pain dysfunction of the temporomandibular joint, taking into account the peculiarities of the personality and compliance. Stomatology for All / Int. Dental Review. 2020; No.1(90): 44-50 (In Russian). doi: 10.35556/idr-2020-1(90)44-50
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