{"id":684,"date":"2025-05-09T08:22:58","date_gmt":"2025-05-09T08:22:58","guid":{"rendered":"https:\/\/headacheproject.eu\/?p=684"},"modified":"2026-10-08T21:50:39","modified_gmt":"2026-10-08T18:50:39","slug":"understanding-tmj-disorders","status":"publish","type":"post","link":"https:\/\/headacheproject.eu\/ro\/understanding-tmj-disorders\/","title":{"rendered":"\u00cen\u021belegerea tulbur\u0103rilor TMJ"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Articula\u021bia temporo-mandibular\u0103 este articula\u021bia maxilarului din fa\u021ba canalului auditiv extern. Este activ\u0103 atunci c\u00e2nd vorbi\u021bi, m\u00e2nca\u021bi sau \u00eenghi\u021bi\u021bi. Se mi\u0219c\u0103 u\u0219or atunci c\u00e2nd deschide\u021bi \u0219i \u00eenchide\u021bi gura.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Cum s\u0103 recuno\u0219ti aceast\u0103 tulburare temporomandibular\u0103\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Durere,\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Durere articular\u0103 \u00een fa\u021ba urechii, care se poate extinde \u00een canalul auditiv extern. Durere de tip \u00een\u021bep\u0103tur\u0103.\u00a0<\/span><\/p>\n<p><strong>Prezen\u021ba disfunc\u021biilor care afecteaz\u0103 activit\u0103\u021bile mandibulare:\u00a0<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">Lips\u0103 de amplitudine la deschidere,\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">Dificultate \u0219i durere la mestecat.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Fizioterapia va avea un efect pozitiv dac\u0103 ave\u021bi dureri la nivelul maxilarului \u0219i prezen\u021ba disfunc\u021biilor, adic\u0103 lipsa deschiderii \u0219i\/sau dificult\u0103\u021bi la mastica\u021bie. Primul lucru de \u00eencercat este un tratament fizioterapeutic care combin\u0103 terapia manual\u0103 cu exerci\u021bii prescrise, pentru a v\u0103 \u00eenv\u0103\u021ba cum s\u0103 v\u0103 relaxa\u021bi maxilarul \u0219i s\u0103 \u00eent\u0103ri\u021bi mu\u0219chii superficiali \u0219i profunzi ai g\u00e2tului. Recomandarea unei gutiere ocluzale este indicat\u0103 \u00een cazul durerii \u0219i rigidit\u0103\u021bii matinale bilaterale la trezire, durere care scade pe parcursul zilei.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Aceast\u0103 afec\u021biune este foarte des asociat\u0103 cu parafunc\u021bii, \u00eensemn\u00e2nd c\u0103 scr\u00e2\u0219ni\u021bi din\u021bii tot timpul sau aproape tot timpul, v\u0103 roade\u021bi unghiile... Parafunc\u021biile sunt legate de suprasolicitarea maxilarului sau de o perioad\u0103 de stres\/oboseal\u0103 crescut\u0103. Corpul r\u0103spunde prin \u00eencle\u0219tarea din\u021bilor.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Zgomotul articular este grav? Nu, nu este grav! Acesta este legat de.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Pentru un zgomot articular singur, fizioterapia nu va ajuta. Pe de alt\u0103 parte, dac\u0103 un zgomot este asociat cu pl\u00e2ngerile men\u021bionate mai sus, fizioterapia poate oferi u\u0219urare.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Acest zgomot poate ap\u0103rea \u0219i disp\u0103rea \u00een diferite etape ale vie\u021bii. Mecanismul de apari\u021bie nu este \u00eentotdeauna clar. Cum apare un zgomot articular? \u00cen cazul maxilarului, este oase care se potrive\u0219te \u00een arcada \u00een care se afl\u0103 discul. \u00cen cele din urm\u0103, discul se deformeaz\u0103 \u0219i se deplaseaz\u0103 de pe pozi\u021bia sa, rezult\u00e2nd zgomotul articular. Aceast\u0103 deformare face parte din procesul normal de \u00eemb\u0103tr\u00e2nire a corpului uman.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Este sc\u00e2r\u021b\u00e2itul ATM un pericol real?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Tulbur\u0103rile articula\u021biei temporomandibulare (ATM) sunt un set complex de afec\u021biuni care afecteaz\u0103 articula\u021bia ce une\u0219te maxilarul de craniu, precum \u0219i mu\u0219chii din jur. Aceste tulbur\u0103ri se manifest\u0103 printr-o varietate de simptome, de la durere, limit\u0103ri de mi\u0219care \u0219i zgomote articulare, p\u00e2n\u0103 la disfunc\u021bii mai profunde. Aproximativ 10-12% din popula\u021bie sufer\u0103 de aceasta, dar doar 1-2% apeleaz\u0103 la tratament profesional, deseori la un medic dentist sau kinetoterapeut. Acest nivel sc\u0103zut de solicitare a tratamentului ar putea fi cauzat de lipsa de \u00een\u021belegere a op\u021biunilor de \u00eengrijire, sau de confuzia cu privire la cine s\u0103 consulte.<\/span><\/p>\n<h2>Profiluri de pacien\u021bi \u0219i tipuri de DTM<\/h2>\n<p><span style=\"font-weight: 400;\">Profilul pacien\u021bilor variaz\u0103 \u00een func\u021bie de v\u00e2rst\u0103 \u0219i sex. Femeile sunt afectate mai frecvent, adesea cu durere \u0219i limit\u0103ri func\u021bionale. Pe de alt\u0103 parte, b\u0103rba\u021bii \u00een jurul v\u00e2rstei de patruzeci de ani tind s\u0103 sufere de subluxa\u021bii sau zgomote articulare f\u0103r\u0103 dureri majore. Persoanele \u00een v\u00e2rst\u0103, \u00eentre timp, sunt mai predispuse la tulbur\u0103ri degenerative ale ATM, care pot duce la durere, 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 fiecare caz unic \u00een prezentarea \u0219i tratamentul s\u0103u.<\/span><\/p>\n<h2>Factori de risc: de ce dezvolt\u0103m tulbur\u0103ri ale ATM?<\/h2>\n<p><span style=\"font-weight: 400;\">Exist\u0103 numeroase cauze ale tulbur\u0103rilor ATM, bazate pe o interac\u021biune complex\u0103 de factori biopsihosociali. Pentru a simplifica, exist\u0103 trei tipuri principale de factori:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Comportamental<\/b><span style=\"font-weight: 400;\">Parfunc\u021biile, cum ar fi scr\u00e2\u0219nitul din\u021bilor sau mestecatul excesiv de gum\u0103, sunt comportamente comune care contribuie la DTM.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Psihosocial<\/b><span style=\"font-weight: 400;\">Anxietatea, depresia, somatizarea \u0219i catastrofizarea 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;\">Anumite genotipuri pot predispune la durere cronic\u0103, de\u0219i acesta este \u00eenc\u0103 un domeniu de cercetare emergent.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Tulbur\u0103ri de somn<\/b><span style=\"font-weight: 400;\">: Privarea de somn sau afec\u021biuni precum apneea pot contribui, de asemenea, la dezvoltarea TMD.<\/span><\/li>\n<\/ol>\n<h2><span style=\"font-weight: 400;\">Semne de avertizare: Steaguri ro\u0219ii \u0219i steaguri galbene<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">De\u0219i <\/span><b>semnale de alarm\u0103<\/b><span style=\"font-weight: 400;\"> pentru disfunc\u021biile temporomandibulare (DTM) nu sunt \u00eentotdeauna u\u0219or de identificat, anumite simptome ar trebui s\u0103 dea dovad\u0103 de vigilen\u021b\u0103. Durerea orofacial\u0103, \u00een special dac\u0103 se agraveaz\u0103 \u00een timpul func\u021biei articulare, necesit\u0103 o evaluare atent\u0103. De asemenea, este important s\u0103 se ia \u00een considerare orice istoric de cancer sau infec\u021bii dentare netratate, cum ar fi cariile sau pulpitele, care pot necesita sfatul medical de specialitate \u00eenainte de a lua \u00een considerare reabilitarea fizioterapeutic\u0103.<\/span><\/p>\n<p><b>Steaguri galbene<\/b><span style=\"font-weight: 400;\"> factori psihosociali precum depresia sau anxietatea sever\u0103. \u00cen aceste cazuri, utilizarea unor chestionare validate precum <\/span><b>GAD-7<\/b><span style=\"font-weight: 400;\"> (Tulburare de Anxietate Generalizat\u0103) sau <\/span><b>PHQ-9<\/b><span style=\"font-weight: 400;\"> (Chestionarul de s\u0103n\u0103tate al pacientului) este recomandat pentru a evalua necesitatea unei interven\u021bii suplimentare.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Tratament \u00een cabinet de fizioterapie<\/span><\/h2>\n<p><strong>Evaluare ini\u021bial\u0103<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Evaluarea \u00eencepe cu examinarea mi\u0219c\u0103rilor active \u0219i pasive ale maxilarului \u0219i g\u00e2tului, urmat\u0103 de o palpare atent\u0103 a mu\u0219chilor implica\u021bi, \u00een special a mu\u0219chilor maseter \u0219i temporal. 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 s\u0103 complet\u0103m aceast\u0103 evaluare cu <\/span><b>Scala de limitare func\u021bional\u0103 a maxilarului 20<\/b><span style=\"font-weight: 400;\">, un chestionar care ajut\u0103 la vizarea unor ac\u021biuni specifice de lucru cu pacientul. Acest instrument ajut\u0103, de asemenea, la clarificarea impactului func\u021bional al tulbur\u0103rilor \u0219i la adaptarea mai bun\u0103 a exerci\u021biilor ce urmeaz\u0103 a fi prescrise.<\/span><\/p>\n<p><strong>Palparea intraoral\u0103: o abordare nuan\u021bat\u0103<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">De\u0219i palparea intraoral\u0103 este adesea utilizat\u0103 pentru a evalua ATM, utilitatea sa r\u0103m\u00e2ne limitat\u0103. Este dificil s\u0103 se disting\u0103 durerea real\u0103 de simpla sensibilitate, \u00een special la subiec\u021bii de control, care prezint\u0103 adesea dureri similare. Cu toate acestea,.<\/span><\/p>\n<p><strong>Tratamente: manuale, ex<\/strong><\/p>\n<p><span style=\"font-weight: 400;\">Tratamentele manuale, atunci c\u00e2nd sunt efectuate corect, sunt eficiente pentru TMD. Cu toate acestea, exerci\u021biile specifice \u0219i gestionarea parafunc\u021biilor (cum ar fi str\u00e2ngerea din\u021bilor) sunt elemente cruciale \u00een reabilitare. \u00cen ceea ce prive\u0219te <\/span><b>puncte trigger miofasciale<\/b><span style=\"font-weight: 400;\">, utilizarea sa depinde de pacient \u0219i de terapeut. Poate fi propus\u0103 la caz la caz, \u00een func\u021bie de toleran\u021ba \u0219i preferin\u021bele pacientului.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">DMT \u0219i comorbidit\u0103\u021bi: asocieri frecvente<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">TMD-urile sunt frecvent asociate cu alte tulbur\u0103ri, \u00een special <\/span><b>dureri de cap<\/b><span style=\"font-weight: 400;\">. Studiile arat\u0103 o prevalen\u021b\u0103 mai mare a migrenelor \u0219i cefaleelor de tensiune la pacien\u021bii cu DTM. <\/span><b>Bruxism<\/b><span style=\"font-weight: 400;\"> (scr\u00e2\u0219nirea sau \u00eencle\u0219tarea din\u021bilor) este de asemenea legat\u0103 de aceste tulbur\u0103ri \u0219i poate agrava durerea ATM.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00cen ceea ce prive\u0219te <\/span><b>pozi\u021bie<\/b><span style=\"font-weight: 400;\">, s-a acceptat de mult timp c\u0103 postura avansat\u0103 a capului este un factor de risc major pentru afec\u021biunile articula\u021biei temporomandibulare (ATM). Cu toate acestea, cercet\u0103rile recente arat\u0103 c\u0103 aceast\u0103 leg\u0103tur\u0103 este mai slab\u0103 dec\u00e2t se presupunea. Acestea fiind spuse, abordarea posturii ca parte a tratamentului poate avea efecte benefice prin modularea percep\u021biilor corporale ale pacientului.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Perspective viitoare: cercetare \u0219i direc\u021bii noi<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Cercet\u0103rile viitoare se vor concentra probabil pe leg\u0103tura dintre DTM \u0219i alte afec\u021biuni, cum ar fi <\/span><b>tinitus<\/b><span style=\"font-weight: 400;\"> \u0219i <\/span><b>apnee \u00een somn<\/b><span style=\"font-weight: 400;\">. Aceste domenii ofer\u0103 perspective interesante pentru o mai bun\u0103 \u00een\u021belegere a interac\u021biunilor dintre tulbur\u0103rile musculo-scheletice ale ATM \u0219i alte afec\u021biuni sistemice.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Deplasarea discotic\u0103: un factor \u00een zgomotele articulare, dar nu \u00een durere<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Dislocarea discului articular temporomandibular este adesea subliniat\u0103 \u00een discu\u021biile despre disfunc\u021bia temporomandibular\u0103 (DTM). 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 durere sau tulburare func\u021bional\u0103. Cu alte cuvinte, prezen\u021ba unui zgomot articular asociat cu dislocarea discului nu \u00eenseamn\u0103 neap\u0103rat c\u0103 pacientul va experimenta durere sau func\u021bie afectat\u0103. Acest zgomot este adesea benign, iar tratamentul ar trebui 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>The temporomandibular joint is the jaw joint in front of the external auditory canal. It is active when you speak, eat or swallow. It moves smoothly when you open and close your mouth.\u00a0 How to recognize this temporomandibular disorder\u00a0 Pain in the chewing muscles felt in the cheeks and\/or temples,\u00a0 Joint pain in front of [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":767,"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":[20],"class_list":["post-684","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-understanding-headaches","tag-en"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Understanding TMJ Disorders - 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\/understanding-tmj-disorders\/\" \/>\n<meta property=\"og:locale\" content=\"ro_RO\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Understanding TMJ Disorders - Head Project\" \/>\n<meta property=\"og:description\" content=\"The temporomandibular joint is the jaw joint in front of the external auditory canal. It is active when you speak, eat or swallow. 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