{"id":1230,"date":"2025-05-29T18:48:28","date_gmt":"2025-05-29T18:48:28","guid":{"rendered":"https:\/\/headacheproject.eu\/?p=1230"},"modified":"2026-10-08T21:48:26","modified_gmt":"2026-10-08T18:48:26","slug":"intelegerea-disfunctiilor-temporomandibulare-atm","status":"publish","type":"post","link":"https:\/\/headacheproject.eu\/ro\/intelegerea-disfunctiilor-temporomandibulare-atm\/","title":{"rendered":"\u00cen\u021belegerea disfunc\u021biilor temporomandibulare (ATM)"},"content":{"rendered":"

Articula\u021bia temporomandibular\u0103 (ATM) este articula\u021bia maxilarului, situat\u0103 \u00een fa\u021ba conductului auditiv extern. Aceast\u0103 activ\u0103 c\u00e2nd vorbe\u0219ti, m\u0103n\u00e2nci sau \u00eenghi\u021bi. \u00cen mod normal, se mi\u0219c\u0103 lin c\u00e2nd deschizi \u0219i \u00eenchizi gura.<\/span><\/p>\n

Cum recuno\u0219ti sau disfunc\u021bie temporomandibular\u0103<\/span><\/h2>\n

-Durere \u00een mu\u0219chii implica\u021bi \u00een mastica\u021bie, resim\u021bit\u0103 \u00een obraji \u0219i\/sau \u00een t\u00e2mple<\/span><\/p>\n

-Durere articular\u0103 \u00een fa\u021ba urechii, care se poate extinde \u00een canalul auditiv extern (durere de tip \"ciupire\")<\/span><\/p>\n

Disfunc\u021bii care afecteaz\u0103 activit\u0103\u021bile mandibulare, precum:<\/span><\/p>\n

-Amplitudine redus\u0103 la deschiderea gurii<\/span><\/p>\n

-Dificult\u0103\u021bi \u0219i durere la mestecat<\/span><\/p>\n

Fizioterapia este un efect pozitiv \u00een cazurile \u00een care maxilarul este dureros \u0219i exist\u0103 disfunc\u021bii evidente, cum ar fi deschiderea limitat\u0103 sau mastica\u021bia dificil\u0103. Primul pas este un tratament ce combin\u0103 terapia manual\u0103 cu exerci\u021bii prescrise pentru a relaxa maxilarul \u0219i a \u00eent\u0103ri mu\u0219chii superficiali \u0219i profunzi ai g\u00e2tului. \u00cen caz de durere \u0219i rigiditate bilateral\u0103 diminea\u021ba, care se amelioreaz\u0103 pe parcursul zilei, se recomand\u0103 purtarea unei gutiere ocluzale.<\/span><\/p>\n

Parafunc\u021biile: un factor frecvent asociat<\/span><\/h2>\n

Disfunc\u021bia ATM este adesea legat\u0103 de parafunc\u021bii, adic\u0103 obiceiuri precum \u00eencle\u0219tarea constant\u0103 a din\u021bilor sau rosul unghiilor. Acestea apar de regul\u0103 \u00een perioadele de stres sau oboseal\u0103, iar corpul reac\u021bioneaz\u0103 prin \u00eencordarea involuntar\u0103 a maxilarului.<\/span><\/p>\n

Este zgomotul articular un semn grav?<\/span><\/p>\n

Nu, nu este grav! Este legat de o subluxa\u021bie a discului articular, o structur\u0103 mic\u0103 din articula\u021bie care poate deveni mobil\u0103 \u0219i produce zgomot. Acest sunet nu prezice durere sau disfunc\u021bie! \u00cemb\u0103tr\u00e2nirea, activitatea fizic\u0103 sau modific\u0103rile structurale pot fi factori favorizan\u021bi.<\/span><\/p>\n

Dac\u0103 zgomotul este singurul simptom, fizioterapia nu este necesar\u0103. \u00cens\u0103 dac\u0103 zgomotul este \u00eenso\u021bit de durere sau dificult\u0103\u021bi func\u021bionale, fizioterapia poate fi eficient\u0103.<\/span><\/p>\n

Este clicul ATM un pericol real?<\/span><\/p>\n

Disfunc\u021biile ATM reprezint\u0103 un set complex de afec\u021biuni ce implic\u0103 articula\u021bia dintre mandibul\u0103 \u0219i craniu, precum \u0219i musculatura din jur. Se manifest\u0103 prin simptome variate: durere, limit\u0103ri de mi\u0219care, zgomote articulare \u0219i, uneori, disfunc\u021bii severe.<\/span><\/p>\n

Aproximativ 10-12% din popula\u021bie sufer\u0103 de disfunc\u021bii ATM, dar doar 1-2% caut\u0103 tratament profesionist (dentist sau fizioterapeut). Nivelul sc\u0103zut de solicitare a tratamentului poate fi explicat prin lipsa de informare sau neclaritatea legat\u0103 de specialistul potrivit.<\/span><\/p>\n

Profiluri de pacien\u021bi \u0219i tipuri de disfunc\u021bii ATM<\/span><\/h2>\n
    \n
  • Femeile sunt mai frecvent afectate, adesea cu durere \u0219i limit\u0103ri func\u021bionale.<\/span><\/li>\n
  • B\u0103rba\u021bii \u00een jurul v\u00e2rstei de 40 de ani tind s\u0103 aib\u0103 subluxa\u021bii sau zgomote articulare, dar f\u0103r\u0103 durere sever\u0103.<\/span><\/li>\n
  • Persoanele v\u00e2rstnice dezvolt\u0103 form\u0103 degenerativ\u0103, cu durere, dificult\u0103\u021bi la mestecat sau \u00eenghi\u021bire.<\/span><\/li>\n
  • Factori de risc pentru ATM<\/span><\/li>\n
  • Exist\u0103 o origine biopsihosocial\u0103 complex\u0103, influen\u021bat\u0103 de factori:<\/span><\/li>\n
  • Comportamentali: parafunc\u021bii (\u00eencle\u0219tarea din\u021bilor, mestecatul excesiv de gum\u0103)<\/span><\/li>\n
  • Psihosociali: anxietate, depresie, somatizare, catastrofizare<\/span><\/li>\n
  • Genetici: anumite genotipuri pot favoriza durerea cronic\u0103<\/span><\/li>\n
  • Tulbur\u0103ri de somn: lipsa somnului sau apneea pot agrava\u00a0<\/span><\/li>\n
  • Semnal de alarm\u0103: \"Steaguri ro\u0219ii\" \u0219i \"Steaguri galbene\"<\/span><\/li>\n
  • Steaguri ro\u0219ii: durerea oro-facial\u0103 care se agraveaz\u0103 la mi\u0219carea articula\u021biilor, istoric de cancer sau infec\u021bii dentare netratate (carii\/pulpit\u0103). Acestea necesit\u0103 consult medical \u00eenainte de fizioterapie.<\/span><\/li>\n
  • Steaguri galbene: factori psihosociali (depresie, anxietate sever\u0103) - se recomand\u0103 folosirea unei chestionare validate precum GAD-7 sau PHQ-9 pentru evaluare suplimentar\u0103.<\/span><\/li>\n
  • Tratament \u00een cabinetul de fizioterapie<\/span><\/li>\n<\/ul>\n

    Evaluarea ini\u021bial\u0103<\/span><\/h2>\n

    Include analiza mi\u0219c\u0103rilor active \u0219i pasive ale maxilarului \u0219i g\u00e2tului, urmat\u0103 de palpare atent\u0103 a mu\u0219chilor implica\u021bi (\u00een special maseter \u0219i temporal). Se localizeaz\u0103 durerea \u0219i se evalueaz\u0103 intensitatea pentru a determina dac\u0103 sursa este muscular\u0103 sau articular\u0103.<\/span><\/p>\n

    Chestionarul Jaw Functional Limitation Scale 20 poate fi util pentru a identifica activit\u0103\u021bile afectate \u0219i pentru personalizarea exerci\u021biilor.<\/span><\/p>\n

    Palparea intraoral\u0103: o abordare nuan\u021bat\u0103<\/span><\/p>\n

    De\u0219i este folosit\u0103 pentru evaluarea ATM, palparea intraoral\u0103 sunt o utilitate limitat\u0103. Este dificil de diferen\u021biat \u00eentre durerea real\u0103 \u0219i sensibilitate, mai ales la pacien\u021bi s\u0103n\u0103to\u0219i care pot acuza dureri similare. Totu\u0219i, tehnica poate fi util\u0103 terapeutic pentru desensibilizare. Este esen\u021bial\u0103 o abordare de colaborare cu pacientul, deoarece poate fi perceput\u0103 ca intruziv\u0103.<\/span><\/p>\n

    Tratamente\u00a0<\/span><\/h2>\n

    terapie manual\u0103, exerci\u021bii \u0219i controlul parafunc\u021biilor<\/span><\/p>\n

    Tratamentele manuale, efectuate corect, sunt eficiente. Exerci\u021biile specifice \u0219i controlul parafunc\u021biilor (cum ar fi \u00eencle\u0219tarea din\u021bilor) sunt cruciale. \u00cen unele cazuri, dry needling poate fi folosit, \u00een func\u021bie de toleran\u021ba \u0219i preferin\u021bele pacientului.<\/span><\/p>\n

    ATM \u0219i comorbidit\u0103\u021bi<\/span><\/h2>\n

    Disfunc\u021biile ATM sunt adesea asociate cu alte afec\u021biuni, precum:<\/span><\/p>\n

    Migrene \u0219i dureri de cap tensionale (prevalen\u021b\u0103 mai mare la pacien\u021bii cu disfunc\u021bii ATM)<\/span><\/p>\n

    Bruxismul agraveaz\u0103 durerea ATM<\/span><\/h2>\n

    Postura cu capul proiectat \u00een fa\u021b\u0103 a fost considerat\u0103 mult timp un factor de risc, dar cercet\u0103rile recente arat\u0103 c\u0103 leg\u0103tura nu este at\u00e2t de clar\u0103. Totu\u0219i, educarea posturii poate avea efecte benefice.<\/span><\/p>\n

    Perspective viitoare: cercetare \u0219i noi direc\u021bii<\/span><\/h2>\n

    Studiile viitoare vor investiga leg\u0103tura dintre ATM \u0219i afec\u021biuni precum tinitusul \u0219i apneea de somn, oferind noi perspectiva asupra interac\u021biunilor dintre disfunc\u021biile musculo-scheletale ATM \u0219i alte condi\u021bii sistemice.<\/span><\/p>\n

    Deplasarea discului: zgomot articular, dar f\u0103r\u0103 durere<\/span><\/p>\n

    Deplasarea discului articular ATM este frecvent men\u021bionat\u0103, dar studiile arat\u0103 c\u0103 nu exist\u0103 o leg\u0103tur\u0103 direct\u0103 \u00eentre pozi\u021bia discului \u0219i durere sau disfunc\u021bie. Cu alte cuvinte, prezen\u021ba unui zgomot articular nu \u00eenseamn\u0103 automat durere. Acesta este, de regul\u0103, benign, iar tratamentul trebuie s\u0103 aib\u0103 ca obiectiv reducerea anxiet\u0103\u021bii \u0219i \u00eencurajarea folosirii normale a articula\u021biei.<\/span><\/p>\n

     <\/p>","protected":false},"excerpt":{"rendered":"

    Articula\u021bia temporomandibular\u0103 (ATM) este articula\u021bia maxilarului, situat\u0103 \u00een fa\u021ba conductului auditiv extern. Este activ\u0103 c\u00e2nd vorbe\u0219ti, m\u0103n\u00e2nci sau \u00eenghi\u021bi. \u00cen mod normal, se mi\u0219c\u0103 lin c\u00e2nd deschizi \u0219i \u00eenchizi gura. Cum recuno\u0219ti o disfunc\u021bie temporomandibular\u0103 -Durere \u00een mu\u0219chii implica\u021bi \u00een mastica\u021bie, resim\u021bit\u0103 \u00een obraji \u0219i\/sau \u00een t\u00e2mple -Durere articular\u0103 \u00een fa\u021ba urechii, care se poate […]<\/p>\n","protected":false},"author":1,"featured_media":1204,"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":[8],"class_list":["post-1230","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-understanding-headaches","tag-ro"],"acf":[],"yoast_head":"\n\u00cen\u021belegerea disfunc\u021biilor temporomandibulare (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\/intelegerea-disfunctiilor-temporomandibulare-atm\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u00cen\u021belegerea disfunc\u021biilor temporomandibulare (ATM) - Head Project\" \/>\n<meta property=\"og:description\" content=\"Articula\u021bia temporomandibular\u0103 (ATM) este articula\u021bia maxilarului, situat\u0103 \u00een fa\u021ba conductului auditiv extern. 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