{"id":13881,"date":"2023-11-01T15:08:24","date_gmt":"2023-11-01T15:08:24","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=13881"},"modified":"2023-11-01T15:08:27","modified_gmt":"2023-11-01T15:08:27","slug":"llr-policy-for-temporo-mandibular-joint-dysfunction-tmd","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/pl\/llr-policy-for-temporo-mandibular-joint-dysfunction-tmd\/","title":{"rendered":"Polityka LLR dotycz\u0105ca dysfunkcji staw\u00f3w skroniowo-\u017cuchwowych (TMD)"},"content":{"rendered":"

<\/p>\n\n\n\n

Kategoria<\/strong><\/p>\n\n\n\n

Kryteria progowe<\/p>\n\n\n\n

Zaburzenie stawu skroniowo-\u017cuchwowego (TMD) lub zesp\u00f3\u0142 TMJ to og\u00f3lny termin obejmuj\u0105cy ostre lub przewlek\u0142e zapalenie stawu skroniowo-\u017cuchwowego, kt\u00f3ry \u0142\u0105czy \u017cuchw\u0119 z czaszk\u0105.<\/p>\n\n\n\n

Operacja TMJ, o kt\u00f3rej mowa w tym dokumencie, nie obejmuje artroskopii, poniewa\u017c mo\u017ce by\u0107 wykonana w celach diagnostycznych. <\/p>\n\n\n\n

Uprawnienia<\/strong><\/p>\n\n\n\n

LLR ICB sfinansuje leczenie wy\u0142\u0105cznie po spe\u0142nieniu poni\u017cszych kryteri\u00f3w<\/strong>
\u00a0
Zanim jakikolwiek dentysta lub chirurg rozpocznie jakikolwiek plan lub podej\u015bcie obejmuj\u0105ce operacj\u0119, przeprowadzono dok\u0142adne wyszukiwanie pod k\u0105tem parafunkcyjnych nawyk\u00f3w zwi\u0105zanych ze szcz\u0119k\u0105, a g\u0142\u00f3wnym celem by\u0142a korekta wszelkich rozbie\u017cno\u015bci od normy. Skierowania musz\u0105 potwierdza\u0107 wykonanie nast\u0119puj\u0105cych zabieg\u00f3w:
\u00a0
1. Podp\u00f3rka pod szcz\u0119k\u0119
\u00a0
I<\/strong>
2. Leki: niesteroidowe leki przeciwzapalne, takie jak aspiryna, ibuprofen w celu kontrolowania stanu zapalnego. Leki zwiotczaj\u0105ce mi\u0119\u015bnie, takie jak diazepam, mog\u0105 zmniejsza\u0107 skurcze mi\u0119\u015bni

I<\/strong>
3. Fizjoterapia
\u00a0
I<\/strong>
4. Znieczulenie miejscowe
\u00a0
I<\/strong>
5. Terapia okluzyjna: wykonany na zam\u00f3wienie aparat akrylowy, kt\u00f3ry zak\u0142ada si\u0119 na z\u0119by przepisane na noc i dzie\u0144, aby zr\u00f3wnowa\u017cy\u0107 zgryz, zmniejszy\u0107 i wyeliminowa\u0107 zgrzytanie lub zaciskanie z\u0119b\u00f3w (bruksizm).
\u00a0
I<\/strong>
6. Zastrzyki z toksyny botulinowej.
\u00a0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Operacja jest wskazana dopiero wtedy, gdy zawiod\u0105 te terapie medyczne i jest wykonywana w ostateczno\u015bci.
\u00a0
Naci\u0105gni\u0119cie wi\u0119zade\u0142 TMJ, restrukturyzacja stawu i wymiana stawu s\u0105 rozwa\u017cane tylko w najci\u0119\u017cszych przypadkach uszkodzenia lub pogorszenia stanu staw\u00f3w.
\u00a0
Bezwzgl\u0119dnymi przeciwwskazaniami do zabiegu s\u0105:<\/strong>

\u00b7 Aktywna lub przewlek\u0142a infekcja;
\u00b7 Niewystarczaj\u0105ca ilo\u015b\u0107 lub jako\u015b\u0107 ko\u015bci do podparcia sk\u0142adnik\u00f3w;
\u00b7 Choroba og\u00f3lnoustrojowa o zwi\u0119kszonej podatno\u015bci na infekcje;
\u00b7 Pacjenci z rozleg\u0142ymi perforacjami do\u0142u \u017cuchwy i\/lub ubytkami kostnymi
\u00b7 wynios\u0142o\u015b\u0107 stawowa lub \u0142uk jarzmowy, kt\u00f3ry w znacznym stopniu stanowi\u0142by wsparcie dla
\u00b7 sk\u0142adnik sztucznego do\u0142u;
\u00b7 Cz\u0119\u015bciowa rekonstrukcja stawu TMJ;
\u00b7 Znana reakcja alergiczna na jakiekolwiek materia\u0142y u\u017cyte w sk\u0142adnikach;
\u00b7 Pacjenci z chorobami psychicznymi lub neurologicznymi, kt\u00f3rzy nie chc\u0105 lub nie mog\u0105 przestrzega\u0107 zalece\u0144
\u00b7 instrukcja piel\u0119gnacji pooperacyjnej;
\u00b7 Pacjenci z niedojrza\u0142o\u015bci\u0105 szkieletow\u0105
\u00b7 Pacjenci z powa\u017cnymi nawykami hiperfunkcjonalnymi (np. zaciskanie, zgrzytanie itp.)
<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Przewodnictwo<\/strong><\/p>\n\n\n\n

Przegl\u0105d | Ca\u0142kowita proteza stawu skroniowo-\u017cuchwowego | Wskaz\u00f3wki | \u0141ADNY<\/a><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Data przegl\u0105du ARP 92: 2026 r<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

Category Threshold Criteria Temporo-mandibular joint disorder (TMD), or TMJ syndrome, is an umbrella term covering acute or chronic inflammation of the temporo-mandibular joint, which connects the mandible to the skull. 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