Tag: Fizjoterapia stomatologiczna

The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries

Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz


Szymon Tyszkiewicz, Patrycja Ujma, Dominik Szczeciński, Klaudia Szczygieł, Marcin Kozakiewicz – The assessment of the early rehabilitation’s impact on the level of disorders occurring and the process of reinnervation, on the example of facial twigs of the motor nerve in patients with craniofacial injuries. Fizjoterapia Polska 2022; 22(4); 128-141

DOI: https://doi.org/10.56984/8ZG1A6t5I

Abstract
Introduction. Lymphoedema of the skull’s facial part is one of the main complications observed in a patient after surgical treatment of disorders of this area. Another noticeable and frequently reported complication by the patient is irregularities in facial expression muscles’ work. A relationship between them and reducing edema performed in patients in the first days after surgery will reduce the noted disturbances in motor branches’ function.
Aim. To investigate the impact of early swelling reduction on the extent of nervous system disorders and its reinnervation rate.
Materials and methods. Patients of the Maxillofacial Surgery Clinic of the University Clinical Hospital of the Military Medical Academy in Łódź were enrolled in the study. The study was conducted on 60 people who underwent maxillofacial surgery procedures from February to December 2019. Lymphatic drainage and dynamic taping were used to reduce patients’ edema. Forty-five people were divided into three equal groups. Fifteen patients constituted the comparative group. The research tools were a survey created following the author’s idea, linear measurements for measuring edema, and the Pietruski scale for assessing the state of reinnervation imaged by mimic muscle motility. On the first day after surgery, patients were examined four times, then on the third and seventh day after surgery, and finally four months after surgery.
Results. The use of anti-edema therapy noticeably (from 2-5 points on the Pietruski scale) reduces the disturbances in facial expression muscles’ function. The difference has been visible already on the third day after surgery. Regarding the patient’s pain, the lack of manual lymphatic system development resulted in pain sensations remaining in each of the three tests performed. The occurrence of edema, pain level, and level of facial expression muscle disorders were similar between groups and made the following research objective in terms of observed relationships.
Conclusions. The level of disturbances in the area of the mobility of expressive facial muscles (based on Pietruski scale) indicates that the implementation of anti edematous therapy, and thus the reduction of excess lymph, already in the first days after surgery provides a reduction of disorders of conduction of efferent impulses of motor fibers, appearing already in the first days after surgery. Increased drainage rate also accelerates the reinnervation process, shortens it by several weeks, and reduces pain symptoms.

Key words:
reinnervation, facial nerve, lymphatic oedema, dental physiotherapy

Pobierz/Download/下載/Cкачиваете Download for free (only English version)

Fractures of the condylarprocess of the mandible – the use of comprehensive manual therapy in the reduction of postoperative complications

Szymon Tyszkiewicz, Dominik Szczeciński, Anna Lichnowska, Marta Tyndorf, Marcin Kozakiewicz


Szymon Tyszkiewicz, Dominik Szczeciński, Anna Lichnowska, Marta Tyndorf, Marcin Kozakiewicz – Fractures of the condylarprocess of the mandible – the use of comprehensive manual therapy in the reduction of postoperative complications. Fizjoterapia Polska 2022; 22(3); 80-87

Abstract
Condyloid process fractures are a serious injury to the temporomandibular joints, and the surgical supply of tissues intensifies the occurrence of certain disorders.
These Rehabilitation performed was proposed as a result of complications following surgical reconstruction of broken condyloid process of the mandible. The rate and amount of edema reduction were assessed. Changes in the movement of temporomandibular joints and complex movement of the cervical spine were measured. The rate and extent of reinnervation and the level of pain were controlled.
Mobility of joints and functional abilities of the surrounding systems have significantly improved. The function of the facial nerve has been restored to a small sensory-motor disorder.

Key words:
condyloid process, facial nerve, manual therapy, dental physiotherapy, postoperative disorders

Pobierz/Download/下載/Cкачиваете Download for free (English)

Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects

Szymon Tyszkiewicz, Marcin Kozakiewicz, Marta Tyndorf, Dorota Kościelniak

S. Tyszkiewicz, M. Kozakiewicz, M. Tyndorf, D. Kościelniak – Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects. Fizjoterapia Polska 2019; 19(3); 146-157

Abstract
Aim of the study. Evaluation of the effectiveness of manual techniques and dynamic taping in the reduction of postoperative complications after surgical treatment of orthognathic defects.
Material and methods.50 people were qualified for the tests. These people were between the ages of 16 and 39. They were rehabilitated as a result of the surgical treatment of orthognathic defects. These patients were hospitalized due to postoperative complications such as tissue contractures, adhesions and scars, disturbances in joint mobility of the temporomandibular region and the cervical spine, lymphatic edema and nerve conduction disorders in the facial area. In a few people, additional blood bruising was found.
Dynamic taping was performed for two weeks postoperatively, treatments with massage and manual therapy twice a week (45-60 min. – time of a particular visit) for a period of 3 months, starting from the first week after surgery. The results of the therapy were supported by patients performing the recommended exercises. The rate and amount of edema reduction were assessed. Changes in the movement of temporomandibular joints and complex movement of the cervical spine were measured. The rate and extent of reinnervation and the level of pain were controlled. The Pietruski’s, House and Brackmann’s scales, VAS and linear measurements were used for the assessment.
Results.The average range of mobility in the field of temporomandibular joints and the cervical spine was improved in all examined spatial axes. The edema was significantly reduced, remaining after 3 months of therapy only at the averaged value of 8% of the baseline value.Sensory as well as motor fibers in the reinnervation process regained their functions. Their average state described by Pietruski’s scale results is about 26 points, which in the descriptive assessment corresponds to a small paresis.Post-operative haematomas were absorbed within two weeks of the operation.Pain in patients decreased from 7 points at the beginning of therapy, to 3 points after three weeks (average values). The total reduction occurred on average after 5 weeks.
Conclusions. The therapeutic process carried out had a significant influence on the results achieved. These data are comparable with the results presented in the scientific literature, describing similar issues. The results achieved are statistically significant (p <0.05), referring them to the results of people in the comparative group. As a result of the implemented comprehensive therapy, biomechanics and mobility in temporomandibular joints and spine joints were restored to physiological conditions. The performance of the lymphatic system has increased. The pain sensations have been reduced. There were no significant disturbances in the area of facial expressions and the work of sensory branches on the face. Fascial adhesions and scars have been released, to a condition that does not hinder the return to normal daily activity.

Key words:
orthognathic defects, dental physiotherapy, manual therapy, dynamic taping

Invalid download ID. Download for free (only English version)

Implementation of manual physiotherapeutic activities as an important element of supporting surgical treatment in congenital malformations of the bite and temporomandibular joints – case report

Szymon Tyszkiewicz, Marta Tyndorf, Krzysztof Dowgierd

S. Tyszkiewicz, M. Tyndorf, K. Dowgierd – Implementation of manual physiotherapeutic activities as an important element of supporting surgical treatment in congenital malformations of the bite and temporomandibular joints – case report. Fizjoterapia Polska 2019; 19(3); 38-45

Abstract
Introduction. Surgical procedures used to treat congenital craniofacial malformations may give rise to complications, resulting in impaired function of the stomatognathic system. Reconstructive correction of subsequent defects may require multi-disciplinary skills, including those of maxillofacial and microsurgery, orthodontics, speech therapy and physiotherapy. The purpose of reconstruction to restore function can be divided into two stages: firstly the establishment of correct anatomical relationships in the facial skeleton and secondly the restoration of function of individual structures of the stomatognathic system, together with the stabilisation of both function and appearance. The latter is fundamentally associated with supportive physiotherapy.
Aim of the study. The aim of the study was to determine the effectiveness of physiotherapy in the process of restoring motor functions in the stomatognathic system in a patient treated for disorders of the masticatory apparatus.
Material and methods. The article presents an account of supportive physiotherapy utilised in the healing process. The case study presented is that of a patient with congenital ankylosis of the temporomandibular joints. The patient presented in the maxillofacial department for surgical joint treatment and with associated in activity in the musculature of this region. Initial treatment involved bilateral arthroplasty with prosthetic arthroplasy, after which it was possible to proceed to restoration of functional speech. The provision of physiotherapy over a timescale of six months achieved reduction of oedema, development of the expected range of movement, reduction of pain and the achievement of deglutition.
Results. Results were maintained through continuation of therapeutic procedures, since periods of reduced activity are associated with loss of function. In order to increase functional capacity and achieve stability, the patientis to undergo microtransplantation (cable grafts) and orthodontic treatment to achieve full centricocclusion. Speech therapy and physiotherapy will also be continued.
Conclusions: Supportive physiotherapy should be a key element of treatment of patients after maxillofacial procedures, regardless of whether this is due to injury, congenital malformation ororthognathic procedures.

Key words:
arthroplasty, ankylosis, dental physiotherapy, temporomandibular joint

Invalid download ID. Download for free (only English version)