Temporomandibular Eklem Disfonksiyonlarında Fizyoterapi ve Rehabilitasyon Yaklaşımları
Özet
Temporomandibular eklem disfonksiyonu (TMED), kraniomandibular sistemin içerisinde yer alan çene ekleminin yapısal veya fonksiyonel değişikleri sonucunda ortaya çıkan klinik tablodur. Çiğneme, konuşma, yutma gibi birçok işlevde önemli rol alan bu eklem, anatomik bozukluklar, maloklüzyon, diş sıkma veya tırnak yeme gibi parafonksiyonel davranışlar gibi birçok faktörden etkilenerek ortaya çıkmaktadır. Ağız açıklığının değişmesi, krepitasyon ve ağrı gibi primer klinik bulgularla seyreden bu disfonksiyona omurga problemleri, postüral değişiklikler ve kas gerginlikleri de eşlik edebilmektedir. Tanı koymak için detaylı klinik muayene, görüntüleme teknikleri ve çeşitli ölçekler kullanılmaktadır. Tedavinin temel amaçları; fonksiyonel ağız açıklığını sağlamak, ağrı kontrolü sağlamak ve sağlıklı bir ağız yapısına ulaşmayı hedeflemektedir. Tedavide splint uygulamaları ve cerrahi tekniklerle beraber egzersiz, manuel terapi, elektroterapi gibi fizyoterapi ve rehabilitasyon uygulamaları yer almaktadır. Bilimsel ve klinik olarak etkili olduğu gösterilen ve multidisipliner bakış açısıyla desteklenen tedavi yaklaşımlarının TMED tedavisinde kullanılması hastalığın önlenmesi ve iyileştirilmesi önemli yer tutmaktadır.
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