CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS AND GENDER-AGE FEATURES OF TEMPOROMANDIBULAR DISORDERS IN PATIENTS WITH A POSITIVE HAMBURG TEST

Abstract

Temporomandibular disorders remain one of the most complex and prevalent pathologies of the maxillofacial region. The prolonged subclinical course and multifactorial nature of occlusal-articular dysfunctions frequently lead to delayed diagnosis, often at the stage of irreversible morphological changes within the joint. The aim of the study was to conduct a comparative analysis of the clinical and epidemiological structure and to determine the gender and age-related features of temporomandibular disorders progression in patients at the stage of primary manifestation of occlusal-articular dysfunction (based on the criteria of a positive Hamburg test) to substantiate differentiated approaches to early diagnosis and comprehensive rehabilitation. Materials and methods. A comprehensive clinical and epidemiological examination of 168 patients with a positive Hamburg test was conducted. The subjects were divided into male (n=62) and female (n=106) cohorts, each further stratified into two age subgroups: young adults (18-45 years) and mature adults (46-59 years). The screening involved manual and instrumental assessment of six key biomechanical parameters of the dentofacial system. Statistical processing and data validation (using ANOVA algorithms) were performed in «Statistica 13.0» software. Results. It was established that, regardless of gender, the predominant symptoms of dysfunction were articular sound phenomena (72.58 % in men and 74.53 % in women) and myofascial pain (53.23 % and 61.32 %, respectively). Intergroup comparisons revealed no statistically significant differences in the frequency of symptoms, p>0.05, indicating the clinical universality of the primary manifestations of the pathology. However, a clear trend toward symptom progression was recorded in the older age group of both genders: in individuals aged 46-59 years, the frequency of extra-articular manifestations (cephalgia, otalgia) and jaw locking phenomena increased by 1.2-1.4 times. The overall frequency and severity of complaints consistently prevailed in female patients. Conclusions. Thus, the conducted study established that the primary clinical markers of temporomandibular disorders manifestation are articular noises and myofascial pain. Furthermore, a distinct trend toward age-related disease progression was observed, characterized by an increase in extra-articular manifestations in individuals aged 46-59 years, alongside a higher frequency of complaints in women. These findings highlight the influence of gender and age-related factors and substantiate the necessity of implementing differentiated algorithms for gnathological rehabilitation.