| Abstract | Uvod: Poremećaj temporomandibularnog zgloba (PTMZ) definira se kao poremećaj strukture i funkcije samog zgloba, a obuhvaća brojne muskuloskeletne poremećaje koji se odnose na kompleks čeljusti i ostale okolne strukture. PTMZ-a često se povezuje sa područjem vratne kralježnice te stoga postoje različite teorije i tumačenja navedene problematike vratne kralježnice i temporomandibularnog zgloba. Cilj ovog preglednog rada je, na temelju on-line dostupnih istraživanja, detaljno opisati postojeće mehanizme i teorije koje stoje iza povezanosti između PTMZ-a te poremećaja vratne kralježnice.
Metode: U pregledni rad uključena su istraživanja koja su vezana za problematiku PTMZ-a i poremećaje vratne kralježnice. Istraživanja su prikupljena na temelju pretrage on-line baze podataka: Medline/PubMed, Scopus i Hrčak te na temelju članaka pronađenih preko sekundarne pretrage preko citatne baze. Za pretraživanje Medline baze podataka putem tražilice PubMed koristile su se riječi: “temporomandibular joint disorder“, “neck pain“ i “corelattion“. Filtri koji su bili uključeni su istraživanja na engleskom i hrvatskom jeziku, istraživanja unatrag 7 godina, sustavni pregledni radovi, meta-analize te RCT istraživanja.
Rezultati: Ukupno je u završnu obradu uzeto 43 istraživanja koja su se bavila povezanošću problematike PTMZ-a i pojavnosti boli i poremećaja u vratnoj kralježnici. Ispituju se korelacije i provode razna mjerenja između jakosti mišića, razine zamora kao i boli struktura TMZ-a i vratne kralježnice. Procjenjuju se neurološki aspekti kao i psihološki. Osim biomehanike, važnu komponentu predstavlja i biopsihosocijalni pristup. Neurološke promjene najčešće se događaju zbog konvergencije trigeminocervikalnog kompleksa koji uključuje aferentna vlakna mastikatornih mišića, TMZ-a i područja vratne kralježnice.
Zaključak: Teorije o povezanosti PTMZ-a i poremećaja u vratnoj kralježnici slažu se oko jedne ključne stvari, a to je da ni jedan poremećaj nije zaseban, vremenski se očituje na različite načine i kroz različite anatomske strukture. Neophodna je potreba za istraživanjima koja bi ispitivala psihološke odrednice kod osoba koje pate od jednog i drugog poremećaja zbog detaljnijeg uvida u neurofiziološke promjene koje se dešavaju unutar trigeminocervikalne jezgre, ali i izvan nje. |
| Abstract (english) | Introduction: Temporomandibular joint disorder (TMD) is defined as a disorder of the structure and function of the joint itself, and includes several musculoskeletal disorders related to the jaw complex and other surrounding structures. TMD is often associated with the area of the cervical spine and therefore there are different theories and interpretations of the above-mentioned problems of the cervical spine and temporomandibular joint. This review paper aims to present and describe the existing mechanisms and theories behind the association between TMD and cervical spine disorders, based on online researches.
Methods: This review paper includes researches that are related to the problems of TMD and disorders of the cervical spine. The review was collected based on the searches of the online databases: Medline/PubMed, Scopus, and Hrčak and based on articles found through secondary searches through citation databases. The words "temporomandibular joint disorder", "neck pain" and "correlation" were used to search the Medline database via the PubMed search engine. Filters that were included were: researches in English and Croatian, researches that go back 7 years, systematic review papers, meta-analyses, clinical researches, and RCT researches.
Results: A total of 43 studies were taken into account, which dealt with the connection between the problem of TMD and the incidence of pain and disorders in the cervical spine. Correlations were examined and various measurements were performed between muscle strength, fatigue levels as well as pain structures of the TMJ and cervical spine. Neurological, as well as psychological aspects, were assessed. In addition to biomechanics, an important component in disorders that are researched in this review paper is a biopsychosocial approach. Neurological changes most commonly occur due to the convergence of the trigeminocervical complex involving the afferent fibers of the masticatory muscles, TMJ, and areas of the cervical spine.
Conclusion: Theories about the connection between TMD and cervical spine disorders agree on one key thing, and that is that none of the disorder is separate, they manifest over time in different ways and through different anatomical structures. There is a need for research that would examine the psychological determinants in people suffering from both disorders for a more detailed insight into the neurophysiological changes that occur inside the trigeminocervical nucleus, but also outside it.
Conclusion: Theories about the connection between PTMZ and cervical spine disorders agree on one key thing, and that is – no disorder develops separately, it manifests itself in different ways and in different structures over time. There is a need for research to assess the psychological aspects of people suffering from both disorders to determine in more detail the neurophysiological changes that occur within the trigeminocervical complex. |
