PREDICTION OF TMJ DYSFUNCTION PAIN SYNDROME IN PATIENTS WITH OCCLUSIVE ARTICULATION DISORDERS

Abstract

Among the current, important and most complex problems of modern orthopedic Dentistry, the leading place is occupied by the problems of diagnosis and effective treatment of temporomandibular disorders. Analysis of the sharp increase in annual patient requests and their overall high prevalence are due to the variety of complaints and clinical manifestations of this pathology. Pathology of the temporomandibular joint (TMJ) according to modern studies occurs in 25–65 % of the population. Purpose of the work. Prediction of pain syndrome of functional disorders of the masticatory apparatus when planning orthopedic treatment. Materials and methods of research. To conduct the study, a clinical and laboratory examination and orthopedic treatment of 150 patients with various variants of occlusive disorders were conducted, 90 of them had functional disorders of the masticatory apparatus not accompanied by pain syndrome (comparison group), and 60 patients (main group) had TMJ dysfunction with pain syndrome. With this distribution of sample groups and analysis of clinical and anamnestic data of the examined patients, a multidimensional statistical analysis method was used-the random forest method – an ensemble machine learning algorithm used for classification and regression tasks. This made it possible to create an accurate prognostic model (model sensitivity – 0.967 %, specificity – 0.971 %) of the risk of developing TMJ dysfunction pain syndrome with a Yuden index of 1.0, thereby ensuring the best balance between sensitivity and specificity, minimizing both false-positive and false-negative errors. Conclusions. A multidimensional analysis of the cumulative influence of factors on the risk of developing pain syndrome of functional disorders of the masticatory apparatus in violation of occlusal-articulatory relations allowed us to create a prognostic model (model sensitivity – 0.967 %, specificity – 0.971 %) with a Yuden index of 1.0. This predictive model can serve as an accurate tool for the development of TMJ dysfunction pain syndrome at the planning stage of orthopedic treatment. Prospects for further research. Determination and analysis of the prognostic significance of the influence of established factors on the development of pain syndrome of dysfunction, creation for practical medicine of an easyto- use online application for accurate prediction of pain syndrome of dysfunction, determination of its prevention when planning orthopedic treatment.