{"id":1057,"date":"2025-05-18T15:33:54","date_gmt":"2025-05-18T15:33:54","guid":{"rendered":"https:\/\/headacheproject.eu\/?p=1057"},"modified":"2026-10-08T21:49:51","modified_gmt":"2026-10-08T18:49:51","slug":"comprendre-les-troubles-de-latm","status":"publish","type":"post","link":"https:\/\/headacheproject.eu\/ro\/comprendre-les-troubles-de-latm\/","title":{"rendered":"\u00cen\u021belegerea problemelor ATM-ului"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">L'articulation temporo-mandibulaire est l'articulation de la m\u00e2choire situ\u00e9e devant le conduit auditif externe. Ea este activ\u0103 atunci c\u00e2nd vorbi\u021bi, m\u00e2nca\u021bi sau v\u0103 aviza\u021bi. Ea alunec\u0103 atunci c\u00e2nd o deschide\u021bi \u0219i o \u00eenchide\u021bi.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Cum s\u0103 recunoa\u0219te\u021bi aceast\u0103 problem\u0103 temporo-mandibular\u0103?\u00a0<\/span><\/h2>\n<ul>\n<li><span style=\"font-weight: 400;\">Durere \u00een mu\u0219chii de mastica\u021bie, resim\u021bit\u0103 \u00een joc \u0219i\/sau \u00een timp<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Douleur articulaire devant l'oreille, pouvant s'\u00e9tendre au conduit auditif externe. Douleur de type pincement.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Pr\u00e9sence de dysfonctionnements affectant les activit\u00e9s de la m\u00e2choire :\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Manque d'amplitude \u00e0 l'ouverture,\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Dificult\u0103\u021bi \u0219i dureri la mastica\u021bie.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Fizioterapia are un efect pozitiv \u00een cazul \u00een care m\u0103seaua dumneavoastr\u0103 este dureroas\u0103 \u0219i exist\u0103 disfunc\u021bii, adic\u0103 lips\u0103 de deschidere \u0219i\/sau dificult\u0103\u021bi la mastica\u021bie. Primul lucru pe care trebuie s\u0103-l \u00eencerca\u021bi este un tratament fizioterapeutic care s\u0103 combine terapia manual\u0103 \u0219i exerci\u021biile prescrise, pentru a \u00eenv\u0103\u021ba s\u0103 v\u0103 desface\u021bi g\u00e2tlejul \u0219i s\u0103 v\u0103 \u00eent\u0103ri\u021bi mu\u0219chii superficiali \u0219i profunzi ai g\u00e2tului. Punerea \u00een aplicare a unei gute ocluzale este recomandat\u0103 \u00een caz de dureri \u0219i de raiduri bilaterale matinale \u0219i la trezire, care se instaleaz\u0103 la sf\u00e2r\u0219itul zilei.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Aceast\u0103 problem\u0103 este foarte des asociat\u0103 cu parafunc\u021bii, adic\u0103 se str\u00e2ng din\u021bii tot timpul sau aproape, se rupe unghiile,... Parafunc\u021biile sunt legate de o suprautilizare a m\u00e2inii sau de o perioad\u0103 de stres\/fatiga accentuat\u0103. Le corps r\u00e9agit en faisant serrer les dents.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Zgomotul articula\u021biilor este grav? Non, ce n'est pas grave ! Este legat de o subluxa\u021bie a discului, o structur\u0103 mic\u0103 \u00een interiorul articula\u021biei dumneavoastr\u0103 care poate fi mai mult sau mai pu\u021bin mobil\u0103 \u00een interiorul acesteia, ceea ce creeaz\u0103 acest zgomot. Acest zgomot nu este predicativ al unei dureri sau al unei disfunc\u021bii! \u00cemb\u0103tr\u00e2nirea, activitatea fizic\u0103 sau modificarea formei structurii pot fi factori favorizan\u021bi.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pentru un singur zgomot de articula\u021bie, fizioterapia nu este de nicio utilitate. \u00cen schimb, dac\u0103 un zgomot este asociat cu pl\u00e2ngerile susmen\u021bionate, fizioterapia poate aduce o ameliorare.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Acest zgomot poate ap\u0103rea \u0219i disp\u0103rea \u00een diferite momente ale vie\u021bii. Le m\u00e9canisme d'apparition n'est pas toujours clair. Cum apare un zgomot de articula\u021bie? \u00cen cazul m\u00e2choirei, este un os care se introduce \u00een arcada unde se afl\u0103 discul. Le disque finit par se d\u00e9former et se d\u00e9centrer, ce qui entra\u00eene un bruit articulaire. Aceast\u0103 deformare face parte din procesul normal de \u00eemb\u0103tr\u00e2nire a corpului uman.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Clicurile de la ATM reprezint\u0103 un pericol real?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tulbur\u0103rile articula\u021biei temporo-mandibulare (TMD) sunt un ansamblu complex de patologii care afecteaz\u0103 articula\u021bia m\u00e2inii \u0219i a craniului, precum \u0219i mu\u0219chii \u00eenconjur\u0103tori. Aceste afec\u021biuni se manifest\u0103 printr-o varietate de simptome, de la durere, de la limitarea mi\u0219c\u0103rilor \u0219i a loviturilor articulare la disfunc\u021bii mai profunde. Aproximativ 10 p\u00e2n\u0103 la 12 % din popula\u021bie sufer\u0103, dar doar 1 p\u00e2n\u0103 la 2 % consult\u0103 un profesionist, adesea un dentist sau un kinetoterapeut. Aceast\u0103 rat\u0103 sc\u0103zut\u0103 de recurs la tratament poate fi datorat\u0103 unei lipse de \u00een\u021belegere a op\u021biunilor de \u00eengrijire sau unei confuzii cu privire la persoana pe care trebuie s\u0103 o consulte.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Profiluri de pacien\u021bi \u0219i tipuri de PTM<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Profilul pacien\u021bilor variaz\u0103 \u00een func\u021bie de v\u00e2rst\u0103 \u0219i sex. Femeile sunt mai frecvent atinse, adesea cu dureri \u0219i limit\u0103ri func\u021bionale. \u00cen schimb, b\u0103rba\u021bii de o p\u0103trime de veac au tendin\u021ba de a suferi de subluxa\u021bii sau de v\u00e2n\u0103t\u0103i articulare f\u0103r\u0103 durere major\u0103. Persoanele \u00een v\u00e2rst\u0103, \u00een ceea ce le prive\u0219te, sunt mai predispuse la afec\u021biuni generice ale ATM, care pot provoca dureri, dificult\u0103\u021bi de mastica\u021bie \u0219i tulbur\u0103ri de degluti\u021bie. Acest spectru de profiluri subliniaz\u0103 diversitatea manifest\u0103rilor clinice, f\u0103c\u00e2nd ca fiecare caz s\u0103 fie unic \u00een prezentarea \u0219i tratamentul s\u0103u.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Factorii de risc: de ce ne confrunt\u0103m cu probleme ale ATM?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Cauzele problemelor ATM sunt multiple \u0219i se bazeaz\u0103 pe o interac\u021biune complex\u0103 de factori biopsihosociologici. Pentru a simplifica, exist\u0103 trei mari tipuri de factori :<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Comportamentale <\/b><span style=\"font-weight: 400;\">: parafunc\u021biile, cum ar fi serrarea din\u021bilor sau mastica\u021bia excesiv\u0103 de gum\u0103 de mestecat, sunt comportamente curente care favorizeaz\u0103 apari\u021bia tulbur\u0103rilor musculo-dentare.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Psihosocial <\/b><span style=\"font-weight: 400;\">: Anxietatea, depresia, somatizarea \u0219i catastrofismul sunt puternic asociate cu agravarea simptomelor.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Genetic\u0103 <\/b><span style=\"font-weight: 400;\">: Certains g\u00e9notypes peuvent pr\u00e9disposer \u00e0 la douleur chronique, bien qu'il s'agisse encore d'un domaine de recherche emergent.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Probleme ale somnului <\/b><span style=\"font-weight: 400;\">: Lipsa de somn sau probleme precum apneea pot contribui \u0219i la dezvoltarea PTM.<\/span><\/li>\n<\/ol>\n<h2><span style=\"font-weight: 400;\">Semne de avertizare : Drapele ro\u0219ii \u0219i drapele galbene<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">De\u0219i nu este \u00eentotdeauna u\u0219or de identificat <\/span><b>semne avant-coureurs <\/b><span style=\"font-weight: 400;\">des troubles TMD, certains sympt\u00f4mes doivent \u00e9veiller la vigilance. Les douleurs orofaciales, en particulier si elles s'aggravent lors du fonctionnement de l'articulation, n\u00e9cessitent une \u00e9valuation minutieuse. De asemenea, este important s\u0103 se ia \u00een considerare orice antecedente de cancer sau de infec\u021bii dentare netratate, cum ar fi cariile sau pulpi\u021bele, care pot necesita un aviz medical specializat \u00eenainte de a se prevedea o educa\u021bie fizioterapeutic\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Les <\/span><b>drapeaux jaunes <\/b><span style=\"font-weight: 400;\">se refer\u0103 la factorii psihosociologici, cum ar fi depresia sau anxietatea sever\u0103. \u00cen aceste cazuri, se recomand\u0103 utilizarea unor chestionare validate, cum ar fi <\/span><b>GAD-7 <\/b><span style=\"font-weight: 400;\">(Tulburarea de anxietate generalizat\u0103) ou le <\/span><b>PHQ-9 <\/b><span style=\"font-weight: 400;\">(Patient Health Questionnaire) pentru a evalua necesitatea unei interven\u021bii mai ample.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Tratament \u00eentr-un cabinet de fizioterapie<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Evaluarea ini\u021bial\u0103<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Bilan\u021bul \u00eencepe cu o evaluare a mi\u0219c\u0103rilor active \u0219i pasive ale m\u00e2inii \u0219i cutiei, urmat\u0103 de o palpare pl\u0103cut\u0103 a mu\u0219chilor afecta\u021bi, \u00een special a mu\u0219chilor masivi \u0219i temporali. Localizarea durerii \u0219i evaluarea intensit\u0103\u021bii acesteia sunt esen\u021biale pentru a determina dac\u0103 cauza este muscular\u0103 sau articular\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Poate fi util\u0103 completarea acestei evalu\u0103ri prin <\/span><b>Scala de limitare func\u021bional\u0103 a maxilarului 20<\/b><span style=\"font-weight: 400;\">, un chestionar care permite selectarea unor ac\u021biuni specifice pentru lucrul cu pacientul. Acest instrument permite, de asemenea, s\u0103 se precizeze impactul func\u021bional al problemelor \u0219i s\u0103 se adapteze mai bine exerci\u021biilor de prescriere.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Palpation intra-orale : une approche nuanc\u00e9e<\/span><\/p>\n<p><span style=\"font-weight: 400;\">De\u0219i palparea intraoral\u0103 este adesea utilizat\u0103 pentru evaluarea ATM, utilitatea sa r\u0103m\u00e2ne limitat\u0103. Este dificil s\u0103 se disting\u0103 o durere real\u0103 de o simpl\u0103 sensibilitate, \u00een special la subiec\u021bii martori care prezint\u0103 adesea o durere similar\u0103. Cu toate acestea, aceast\u0103 tehnic\u0103 poate fi benefic\u0103 \u00een cadrul tratamentului pentru desensibilizarea zonei dureroase. Este important s\u0103 r\u0103m\u00e2ne\u021bi \u00een colaborare cu pacientul, deoarece aceast\u0103 abordare poate fi perceput\u0103 ca intruziv\u0103.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Traitements : manuels, exercices et gestion des parafonctions<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tratamentele manuale, atunci c\u00e2nd sunt efectuate corect, sunt eficiente pentru problemele musculo-squelettice. Cu toate acestea, exerci\u021biile specifice \u0219i gestionarea parafunc\u021biilor (cum ar fi serrarea din\u021bilor) sunt elemente esen\u021biale ale educa\u021biei. Quant \u00e0 l\u2019<\/span><b>aiguillage \u00e0 sec<\/b><span style=\"font-weight: 400;\">, utilizarea sa depinde de pacient \u0219i de terapeut. Elle peut \u00eatre proposition au cas par cas, en fonction de la tol\u00e9rance et des pr\u00e9f\u00e9rences du patient.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">TMD \u0219i comorbidit\u0103\u021bi: asocia\u021bii frecvente<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">PTM sunt adesea asociate cu alte probleme, \u00een special <\/span><b>maux de t\u00eate<\/b><span style=\"font-weight: 400;\">. Studiile arat\u0103 o prevalen\u021b\u0103 mai ridicat\u0103 a migrenelor \u0219i a cefaleelor de tensiune la pacien\u021bii care sufer\u0103 de TMD. <\/span><b>Le bruxisme <\/b><span style=\"font-weight: 400;\">(serrement ou grincement des dents) este legat \u0219i de aceste probleme \u0219i poate agrava durerile ATM-ului.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00cen ceea ce prive\u0219te postura, se admite de mult timp c\u0103 pozi\u021bia capului \u00een fa\u021b\u0103 este un factor de risc major pentru tulbur\u0103rile articula\u021biei temporo-mandibulare. Cu toate acestea, cercet\u0103rile recente arat\u0103 c\u0103 aceast\u0103 leg\u0103tur\u0103 este mai slab\u0103 dec\u00e2t se credea. Cela dit, la prise en compte de la posture dans le cadre d'un traitement peut avoir des effets b\u00e9n\u00e9fiques en modulant les perceptions corporelles du patient.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Perspectives d'avenir : recherche et nouvelles orientations<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Cercet\u0103rile viitoare se vor concentra probabil pe leg\u0103tura dintre ATM \u0219i alte patologii, cum ar fi <\/span><b>acufene <\/b><span style=\"font-weight: 400;\">\u0219i l\u2019<\/span><b>Apn\u00e9e du sommeil<\/b><span style=\"font-weight: 400;\">. Aceste domenii ofer\u0103 perspective interesante pentru a \u00een\u021belege mai bine interac\u021biunile dintre tulbur\u0103rile musculo-squelettice ale ATM \u0219i alte afec\u021biuni sistemice.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Le d\u00e9placement du disque : un facteur de bruit articulaire, mais pas de douleur<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Le d\u00e9placement du disque articulaire de l'ATM est souvent mis en avant dans les discussions sur les troubles musculo-squelettiques. Cu toate acestea, mai multe studii au ar\u0103tat c\u0103 nu exist\u0103 o leg\u0103tur\u0103 direct\u0103 \u00eentre pozi\u021bia discului \u0219i durerea sau tulbur\u0103rile func\u021bionale. \u00cen alte cuvinte, prezen\u021ba unui zgomot articular asociat deplas\u0103rii discului nu \u00eenseamn\u0103 neap\u0103rat c\u0103 pacientul sufer\u0103 de o durere sau de o tulburare func\u021bional\u0103. Acest zgomot este adesea b\u00e9nin, iar tratamentul trebuie s\u0103 vizeze lini\u0219tirea pacientului \u0219i \u00eencurajarea utiliz\u0103rii normale a articula\u021biei.<\/span><\/p>\n<p><br style=\"font-weight: 400;\" \/><br style=\"font-weight: 400;\" \/><\/p>","protected":false},"excerpt":{"rendered":"<p>L&#8217;articulation temporo-mandibulaire est l&#8217;articulation de la m\u00e2choire situ\u00e9e devant le conduit auditif externe. Elle est active lorsque vous parlez, mangez ou avalez. Elle glisse lorsque vous l&#8217;ouvrez et la fermez.\u00a0 Comment reconna\u00eetre ce trouble temporo-mandibulaire ?\u00a0 Douleur dans les muscles de la mastication ressentie dans les joues et\/ou les tempes Douleur articulaire devant l&#8217;oreille, pouvant [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":2025,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":"","_yoast_wpseo_canonical":"","footnotes":""},"categories":[21],"tags":[9],"class_list":["post-1057","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-understanding-headaches","tag-fr"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Comprendre les troubles de l&#039;ATM - Head Project<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/headacheproject.eu\/ro\/comprendre-les-troubles-de-latm\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Comprendre les troubles de l&#039;ATM - Head Project\" \/>\n<meta property=\"og:description\" content=\"L&#8217;articulation temporo-mandibulaire est l&#8217;articulation de la m\u00e2choire situ\u00e9e devant le conduit auditif externe. Elle est active lorsque vous parlez, mangez ou avalez. 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