The Condition of the Temporomandibular Joint in Hemiplegia

Overview

Stroke is one of the leading causes of acquired disability worldwide and frequently results in medical complications and long-term sequelae. Depending on the size of the lesions and the cerebral structures affected, sensory, motor, and cognitive impairments, as well as sensory-motor deficits related to the stomatognathic system, may be present after a stroke. The stomatognathic system is a functional complex comprised of structures located in the oral and craniofacial cavities, including skeletal components, head and neck muscles, ligaments, soft tissues, the temporomandibular joint, dental arches, salivary glands, and masticatory muscles. Understanding stomatognathic system disorders is crucial for early diagnosis and implementing rehabilitation approaches to promote functional recovery. Ultrasonography is a widely available, low-cost, non-invasive, and safe medical imaging method that provides real-time observation. It offers several advantages for dentomaxillofacial imaging, including portability, dynamic and repeatable examination capabilities, patient comfort, and accessibility. It is a useful tool in identifying various pathological processes such as temporomandibular joint structures, articular disc displacement, joint effusion, and cortical erosion. There are few studies in the literature specifically on jaw disorders in stroke. The literature is quite limited in examining the jaw structure, muscles, and ligaments, as well as investigating the effect of chewing function on the clinical picture. The investigators aimed to evaluate the temporomandibular joint and chewing function in patients who developed stroke following a cerebrovascular event, and to investigate their relationship with clinical parameters.

Stroke is one of the leading causes of acquired disability worldwide and frequently leads to medical complications and long-term sequelae. Depending on the size of the lesions and the cerebral structures affected, sensory, motor, and cognitive impairments, along with sensory-motor deficits related to the stomatognathic system, may be present after stroke . These patients may develop reduced biting force, stomatognathic disorders related to chewing quality, bruxism, joint clicking, and other temporomandibular joint disorders, which can profoundly affect their swallowing, chewing, and phonation functions, and consequently their quality of life . The stomatognathic system is a functional complex composed of structures located in the oral and craniofacial spaces, including skeletal components, head and neck muscles, ligaments, soft tissues, the temporomandibular joint, dental arches, salivary glands, and masticatory muscles. Understanding stomatognathic system disorders is crucial for early diagnosis and implementing rehabilitation approaches to support functional recovery . Diagnosis of temporomandibular joint disorders is usually based on medical history and physical examination. During the examination, attention is paid to temporomandibular joint (TMJ) range of motion, jaw sounds, and mandibular deviations. If there are suspicious findings in the anamnesis and physical evaluation, diagnostic tools such as computed tomography and magnetic resonance imaging can be used . Ultrasonography is a widely available, low-cost, non-invasive, and safe medical imaging method that provides real-time observation. It offers several advantages for dentomaxillofacial imaging, such as portability, dynamic and repeatable examination possibilities, patient comfort, and accessibility. It is a useful tool in identifying different pathological processes such as temporomandibular joint structures, joint disc displacement, joint effusion, and cortical erosion . There are few studies in the literature, particularly regarding jaw disorders in stroke. The literature examining the jaw structure, muscles, and ligaments, as well as investigating the effect of chewing function on the clinical picture, is quite limited. The investigators aimed to evaluate temporomandibular joint and masticatory function in patients who developed stroke following a cerebrovascular event, and to investigate its relationship with clinical parameters. The investigators aims to improve the quality of life and rehabilitation of participants by examining all areas of rehabilitation, including sensory, motor, and cognitive aspects, as well as evaluating their jaw function, particularly swallowing, in our stroke rehabilitation clinic. It is anticipated that this will enable steps towards early diagnosis and prevention.