METHOD OF MINIMALLY INVASIVE SURGICAL TREATMENT OF INTERNAL DISCREPANCY OF TEMPOROMANDIBULAR JOINT, FOLLOWED BY SLIPPED ARTICULAR DISK, WITH ARTHROCENTESIS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used in the treatment of internal discrepancy of the temporomandibular joint (TMJ). For this purpose, arthrocentesis is performed. Palpation determination of the front-lower edge of the head of the lower jaw (point "A") and the upper-back surface of the head of the lower jaw (point "B") is carried out. Use 2 standard hypodermic needles. Injection in point "A" is carried out perpendicular to the patient's skin surface with gradual infiltration of soft tissues with anesthetic solution without a vasoconstrictor in an amount of 1 ml prior to contact with the anterolateral surface of the condylar process above the attachment point of the TMJ capsule. When arthropuncture in the area of the point "B" injection and the promotion of the needle up at an angle of 45° to the zygomatic arch is carried out before contact with the cortical plate of the mandibular fossa of the temporal bone with constant infiltration of soft tissues with an anesthetic solution followed by the introduction of 1 ml of anesthetic solution. Then the needle is removed by 2–3 mm and change its direction perpendicular to the surface of the patient's skin, after which it is reintroduced to contact with the articular surface of the mandible head, another 0.5 ml of anesthetic is injected. Correct position of both needles is monitored and corrected, if necessary, by ultrasound. After reaching local anesthesia under ultrasound control, first alternate and then synchronous injection of sterile saline is performed at point “A” and at point “B” under pressure in an amount necessary to connect two fluid flows in the lower joint space.;EFFECT: method provides an effective treatment of this pathology, including treatment of anterior, anterolateral or lateral displacement of the articular disc relative to the head of the mandible, allowing to increase the volume of both articular spaces due to the most accurate supply of the solution into the joint cavity, rupture of fibrous adhesions, which has a positive effect on the conditions for correcting the deformity of the articular disc and normalizing its position.;1 cl, 2 ex