Magnetic Resonance Imaging in Patients with Deep Bite and Disorders of the Musculoskeletal Complex

Abstract

The trend towards the progression of the prevalence of deep bite pathology among patients with a permanent bite, as well as clinical manifestations of temporomandibular joint dysfunction in them, prompts an in-depth diagnosis not only of the state of the dental and jaw apparatus but also the analysis of the morphology of bone and soft tissue structural elements TMJ.

The work aimed to study and analyze the peculiarities of the position and condition of the structural elements of the temporomandibular joints of patients with a deep bite and clinical manifestations of TMJ dysfunction.

Research materials and methods. For a comprehensive analysis, magnetic resonance imaging was chosen, as it allows visualization of not only the bony elements of the joints but also the soft tissues that are the direct elements of the temporomandibular joints and surrounding them. 75 patients with deep bite and TMJ disorders were examined. The study presents the main results of measurements of the ratios of the TMJ elements (the dimensions of the anterior, upper, and posterior articular bristles; the depth of the mandibular fossa), as well as the morphological changes of the TMJ structural elements that occurred as a result of the impact of a pathological bite. Patients were divided into two study groups depending on the  degree of clinical manifestation of their dysfunction (with mild (h = 1–2) and medium (h = 5–6) degrees of severity, according to Helkimo). According to the angle of inclination of the upper incisors, there was a division into subgroups within the studied groups. According to the results of the MRI analysis of the patients of the studied clinical groups, it was found that in subjects with retrusion of upper incisors (2 subgroups of I and II groups), an upper anterial displacement of the articular heads of the lower jaw was registered, in subjects with the normal inclination of incisors and protrusion (1 subgroup of I and II groups), an upper posterior displacement of the articular condyles was registered. The anterior joint gap is larger in the examined patients of 2 subgroups of I and II groups, and the mandibular fossa is deeper in patients of 1 subgroup of I and II groups.

Conclusion: displacement of the articular processes of the lower jaw of patients with retrusion of upper incisors is strongly posterior. The results justify the need for further and detailed research into this pathology.