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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.33667/2078-5631-2024-18-85-90</article-id><article-id custom-type="elpub" pub-id-type="custom">medalphabet-3915</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СТОМАТОЛОГИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>DENTISTRY</subject></subj-group></article-categories><title-group><article-title>Оптимизация лечения пациентов с внутренними нарушениями височно-нижнечелюстного сустава</article-title><trans-title-group xml:lang="en"><trans-title>Optimizing the treatment of patients with intrinsic temporomandibular joint disorders</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3532-983X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Казарян</surname><given-names>Г. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Kazarian</surname><given-names>G. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Казарян Генрих Геворгович, аспирант, кафедра челюстно-лицевой хирургии и хирургической стоматологии</p><p>AuthorID: 1127744</p></bio><bio xml:lang="en"><p>Kazarian Genrikh Gevorgovich, postgraduate at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry</p><p>AuthorID: 1127744</p><p>Moscow</p></bio><email xlink:type="simple">genro96@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3897-2019</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бекреев</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Bekreev</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бекреев Валерий Валентинович, д.м.н., профессор кафедры челюстнолицевой хирургии и хирургической стоматологии</p><p>AuthorID: 84948</p></bio><bio xml:lang="en"><p>Bekreev Valery Valentinovich, DDS, Professor, Department of Oral and Maxillofacial Surgery and Surgical Dentistry</p><p>AuthorID: 84948</p><p>Moscow</p></bio><email xlink:type="simple">bekreev@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4098-5663</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кладничкин</surname><given-names>И. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Kladnichkin</surname><given-names>I. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кладничкин Игорь Дмитриевич, аспирант кафедры челюстно-лицевой хирургии и хирургической стоматологии</p><p>AuthorID: 1085413</p></bio><bio xml:lang="en"><p>Kladnichkin Igor Dmitrievich, postgraduate at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry</p><p>AuthorID: 1085413</p><p>Moscow</p></bio><email xlink:type="simple">igorkladnichkin@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4415-766X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Салех</surname><given-names>К. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Salekh</surname><given-names>K. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Салех Карина Мустафаевна, аспирант, кафедра челюстно-лицевой хирургии и хирургической стоматологии</p><p>Author ID: 1154438</p><p> </p></bio><bio xml:lang="en"><p>Salekh Karina Mustafaevna, postgraduate at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry</p><p>Author ID: 1154438</p><p>Moscow</p></bio><email xlink:type="simple">salekh.karina@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7799-3878</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дегтярев</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Degtyarev</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дегтярев Никита Евгеньевич, аспирант, кафедра челюстно-лицевой хирургии и хирургической стоматологии</p><p>Author ID: 1249054</p><p> </p></bio><bio xml:lang="en"><p>Degtyarev Nikita Evgenyevich, postgraduate at the Department of Oral and Maxillofacial Surgery and Surgical Dentistry</p><p>Author ID: 1249054</p><p>Moscow</p></bio><email xlink:type="simple">dr.degtyarev.n@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы», Российская Федерация</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Autonomous Educational Institution of Higher Education «Russian Peoples Friendship University named after Patrice Lumumba», Russian Federation</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>02</day><month>11</month><year>2024</year></pub-date><volume>0</volume><issue>18</issue><issue-title>Стоматология (3)</issue-title><fpage>85</fpage><lpage>90</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Казарян Г.Г., Бекреев В.В., Кладничкин И.Д., Салех К.М., Дегтярев Н.Е., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Казарян Г.Г., Бекреев В.В., Кладничкин И.Д., Салех К.М., Дегтярев Н.Е.</copyright-holder><copyright-holder xml:lang="en">Kazarian G.G., Bekreev V.V., Kladnichkin I.D., Salekh K.M., Degtyarev N.E.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/3915">https://www.med-alphabet.com/jour/article/view/3915</self-uri><abstract><p>Дисфункции височно-нижнечелюстного сустава (ВНЧС) представляют собой состояния, при которых наблюдается нарушение анатомических и функциональных взаимосвязей между различными структурами сустава, включая суставной диск, внутрисуставные связки, головку нижней челюсти и капсулу. Эти нарушения оказывают негативное воздействие на качество жизни пациента, приводя к ограничениям в жевательной функции и артикуляции. Многофакториальная природа этой патологии подчеркивает необходимость индивидуального и комплексного подхода к лечению каждого пациента. В большинстве случаев лечение включает в себя как хирургические, так и ортопедические методы. В настоящее время активно разрабатываются комбинированные подходы лечения, направленные на синергетическое воздействие с целью максимизации терапевтических результатов.</p><sec><title>Цель исследования</title><p>Цель исследования. Оценить эффективность комбинации лечения репозиционной каппой с применением метода гидравлической репозиции суставного диска у пациентов с внутренними нарушениями ВНЧС, сочетающимися с концевыми дефектами зубного ряда. </p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В рамках исследования приняло участие 6 пациентов с дисфункцией ВНЧС и имеющих концевые дефекты зубного ряда. Исследование проводилось в период с сентября 2023 по май 2024 года. В рамках исследования каждому пациенту была проведена конусно-лучевая компьютерная томография (КЛКТ) для оценки состояния костных структур ВНЧС, а также ультразвуковое исследование (УЗИ) для оценки мягкотканных структур данного сустава.</p></sec><sec><title>Результаты исследования</title><p>Результаты исследования. Данные КЛКТ показали, что среднее значение задней части височно-нижнечелюстного сустава до лечения составляло 1,67, в то время как после лечения это значение увеличилось до 3,02. Результаты ультразвукового исследования показали значительное снижение среднего значения показателя смещения головки нижней челюсти после лечения в диапазоне от 0,21 до 0,03, что свидетельствует о положительном эффекте лечения. Кроме того, наблюдалось уменьшение разницы в размерах передней и задней частей суставного диска, что подтверждало устранение его смещения.</p></sec><sec><title>Заключение</title><p>Заключение. Комбинация лечения в сочетании использования репозиционной каппы с методом гидравлической репозиции показала синергетический эффект для восстановления функции ВНЧС.</p></sec></abstract><trans-abstract xml:lang="en"><p>Temporomandibular joint (TMJ) dysfunctions are conditions in which there is a disruption in the anatomical and functional relationship between the various structures of the joint, including the articular disc, intra-articular ligaments, mandibular head and capsule. These disorders have a negative impact on the patient’s quality of life, resulting in limitations in masticatory function and articulation. The multifactorial nature of this pathology emphasizes the need for an individualized and comprehensive approach to the treatment of each patient. In most cases, treatment includes both surgical and orthopedic methods. Currently, combined treatment approaches aimed at synergistic effects are being actively developed to maximize therapeutic </p><sec><title>Results</title><p>Results.</p><p>The purpose of this study. To evaluate the efficacy of the combination of treatment with a repositioning mouthguard and the use of the hydraulic articular disk repositioning method in patients with internal TMJ disorders combined with dental row end defects.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included 6 patients with TMJ dysfunction and end defects of the dentition. The study was conducted between September 2023 and May 2024. As part of the study, each patient underwent cone beam computed tomography (CBCT) to evaluate the bony structures of the TMJ and ultrasound (US) to evaluate the soft tissue structures of this joint.</p></sec><sec><title>Results</title><p>Results. The CBCT data showed that the mean posterior temporomandibular joint displacement before treatment was 1.67, while this value increased to 3.02 after treatment. The US results showed a significant decrease in the mean value of mandibular head displacement after treatment ranging from 0.21 to 0.03, indicating a positive effect of treatment. In addition, there was a decrease in the difference in the size of the anterior and posterior parts of the articular disc, confirming the elimination of its displacement.</p></sec><sec><title>Conclusion</title><p>Conclusion. The treatment combination of using a repositioning mouth guard with the hydraulic repositioning method brought about a synergistic effect on the restoration of TMJ function. </p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>репозиционная каппа</kwd><kwd>артроцентез ВНЧС</kwd><kwd>УЗИ</kwd><kwd>комбинированное лечения ВНЧС</kwd></kwd-group><kwd-group xml:lang="en"><kwd>repositioning mouth guard</kwd><kwd>TMJ arthrocentesis</kwd><kwd>ultrasound</kwd><kwd>combined TMJ treatment</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ivkovic N., Racic M. Structural and functional disorders of the temporomandibular joint (Internal disorders). Maxillofacial surgery and craniofacial deformity-practices and updates. 2018. DOI: 10.5772/intechopen.81937.</mixed-citation><mixed-citation xml:lang="en">Ivkovic N., Racic M. 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