Temporomandibular Eklem ve Sistemik Hastalıkların Etkisi
Özet
Temporomandibular eklem (TME) disfonksiyonları, lokal faktörlerin yanı sıra çeşitli sistemik hastalıkların etkisiyle de ortaya çıkabilmektedir. Bu makalede, TME üzerinde patolojik etki gösterme potansiyeli olan romatolojik, enflamatuar, otoimmün ve dejeneratif sistemik hastalıklar incelenmiştir. Juvenil idiopatik artrit (JİA), osteoartrit (OA), romatoid artrit (RA), psöriatik artrit (PA), reaktif artrit (ReA), septik artrit (SA), ankilozan spondilit (AS), gut, psödogut, sistemik lupus eritamotozus (SLE), sistemik skleroz (SS) ve fibromyalji (FM) gibi hastalıklar; TME'de ağrı, şişlik, eklem sesleri ve hareket kısıtlılığı gibi klinik bulgulara yol açmaktadır. Bu hastalıkların teşhisinde bilgisayarlı tomografi (BT) osseöz değişiklikleri, manyetik rezonans görüntüleme (MRG) ise yumuşak doku ve aktif enflamasyonu göstermede sıklıkla tercih edilir. Tedavi yaklaşımları genellikle spesifik olmamakla birlikte; NSAİ ilaçlar, kortikosteroidler, splint uygulamaları ve fizyoterapi gibi semptomları ve eklem üzerindeki stresi azaltmaya yönelik destekleyici yöntemleri içermektedir. İleri derece eklem harabiyeti veya ankiloz durumlarında ise cerrahi prosedürler devreye girmektedir. Sonuç olarak, diş hekimlerinin TME'yi etkileyebilecek bu sistemik hastalıkları bilmesi, patolojilerin erken teşhisi ve koruyucu tedavilerin uygulanması açısından klinik bir önem taşımaktadır.
Temporomandibular joint (TMJ) dysfunctions can arise not only from local factors but also under the influence of various systemic diseases. This article reviews rheumatologic, inflammatory, autoimmune, and degenerative systemic conditions that possess the potential to exert pathological effects on the TMJ. Disorders such as juvenile idiopathic arthritis (JIA), osteoarthritis (OA), rheumatoid arthritis (RA), psoriatic arthritis (PA), reactive arthritis (ReA), septic arthritis (SA), ankylosing spondylitis (AS), gout, pseudogout, systemic lupus erythematosus (SLE), systemic sclerosis (SS), and fibromyalgia (FM) induce clinical manifestations in the TMJ, including pain, swelling, joint sounds, and restriction of movement. In the diagnostic process, computed tomography (CT) is preferentially utilized to visualize osseous alterations, whereas magnetic resonance imaging (MRI) is preferred for evaluating soft tissues and active inflammation. Although specific cures are generally unavailable, therapeutic approaches predominantly incorporate supportive modalities aimed at mitigating symptoms and joint stress, such as NSAIDs, corticosteroids, occlusal splints, and physical therapy. In cases involving advanced joint destruction or ankylosis, surgical procedures are implemented. Consequently, an awareness of these systemic diseases affecting the TMJ among dentists holds critical clinical significance for early diagnosis and the implementation of preventive treatments.
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