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)