{"id":24101,"date":"2026-08-14T14:52:57","date_gmt":"2026-08-14T11:52:57","guid":{"rendered":"https:\/\/innovationmedical.ro\/?p=24101"},"modified":"2026-08-14T14:58:48","modified_gmt":"2026-08-14T11:58:48","slug":"stomatolog-gnatolog-sau-medic-cine-trateaza-de-fapt-disfunctiile-atm","status":"publish","type":"post","link":"https:\/\/innovationmedical.ro\/en\/stomatolog-gnatolog-sau-medic-cine-trateaza-de-fapt-disfunctiile-atm\/","title":{"rendered":"Stomatolog, gnatolog sau medic? Cine trateaz\u0103, de fapt, disfunc\u021biile ATM?"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"24101\" class=\"elementor elementor-24101\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-b80ef12 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"b80ef12\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c322afb\" data-id=\"c322afb\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a01cf03 elementor-widget elementor-widget-text-editor\" data-id=\"a01cf03\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><em><strong>Ce este <\/strong><\/em><em><strong>gnatologia<\/strong><\/em><em><strong>, de ce ATM se afl\u0103 la grani\u021ba dintre medicin\u0103 \u0219i stomatologie \u0219i de ce diagnosticul modern e adesea multidisciplinar<\/strong><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d8bbbdb elementor-widget elementor-widget-heading\" data-id=\"d8bbbdb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">\u201eM\u0103 doare maxilarul. Bun. Dar la ce medic merg?\"\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a9b0c55 elementor-widget elementor-widget-text-editor\" data-id=\"a9b0c55\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Pare o \u00eentrebare simpl\u0103, p\u00e2n\u0103 \u00eencerci s\u0103-i g\u0103se\u0219ti r\u0103spunsul.\u00a0Dac\u0103 te doare un dinte, mergi la stomatolog. Dac\u0103 te doare genunchiul, te g\u00e2nde\u0219ti la ortoped sau la medicul de recuperare. Dar c\u00e2nd te doare maxilarul, \u00ee\u021bi pocne\u0219te articula\u021bia, nu mai po\u021bi deschide bine gura, ai durere \u00een fa\u021ba urechii, cefalee sau te treze\u0219ti diminea\u021ba cu fa\u021ba \u00eencordat\u0103 lucrurile devin brusc mult mai pu\u021bin clare.<\/p><p>\u00a0<\/p><p>Stomatolog? Medic de recuperare?\u00a0Ortodont? Chirurg oro-maxilo-facial? Neurolog? ORL? Sau \u201egnatolog&#8221;, termen pe care tot mai mul\u021bi pacien\u021bi \u00eel \u00eent\u00e2lnesc pe internet?<\/p><p>\u00a0<\/p><p>Confuzia are o explica\u021bie simpl\u0103: articula\u021bia temporo-mandibular\u0103 st\u0103 exact acolo unde se \u00eent\u00e2lnesc medicina general\u0103 \u0219i medicina dentar\u0103. Iar ce numim generic \u201edisfunc\u021bie ATM&#8221; nu e o singur\u0103 boal\u0103. Conform National Institute of Dental and Craniofacial Research (NIDCR), termenul corect e TMD \u2014 temporomandibular disorders \u2014 un grup de peste 30 de afec\u021biuni care pot interesa articula\u021bia, musculatura care controleaz\u0103 mandibula \u0219i structurile din jur.<\/p><p>\u00a0<\/p><p>A\u0219a c\u0103 \u00eentrebarea corect\u0103 nu e mereu \u201ecare e medicul ATM?&#8221;, ci mai degrab\u0103: <em><strong>ce structur\u0103 produce simptomele mele, \u0219i ce specialist r\u0103spunde la asta?<\/strong><\/em><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3708477 elementor-widget elementor-widget-heading\" data-id=\"3708477\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Ce este, de fapt, gnatologia\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b673dac elementor-widget elementor-widget-text-editor\" data-id=\"b673dac\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Termenul sun\u0103 foarte specializat\u00a0\u0219i tocmai de aceea d\u0103 impresia c\u0103 ar exista o specialitate medical\u0103 dedicat\u0103 exclusiv ATM-ului. Nu chiar.<\/p><p>\u00a0<\/p><p>Gnatologia studiaz\u0103 rela\u021biile func\u021bionale dintre mandibul\u0103, articula\u021biile temporo-mandibulare, din\u021bi, ocluzie \u0219i musculatura masticatorie. A avut un rol important \u00een felul \u00een care \u00een\u021belegem func\u021bia aparatului dento-maxilar, \u0219i r\u0103m\u00e2ne relevant\u0103 \u00een anumite zone ale medicinei dentare.<\/p><p>\u00a0<\/p><p>Problema apare c\u00e2nd termenul e confundat cu ideea c\u0103 orice TMD se explic\u0103 prin ocluzie sau printr-o pozi\u021bie \u201eideal\u0103&#8221; a mandibulei. Medicina contemporan\u0103 s-a \u00eend ep\u0103rtat clar de<\/p><p>explica\u021bia asta unic\u0103. Documentul interna\u021bional INfORM\/IADR privind bunele practici \u00een TMD, publicat la finalul lui 2024, spune exact asta: avertizeaz\u0103 \u00eempotriva modelelor mecaniciste simplificate \u0219i a tratamentelor ireversibile construite pe ideea c\u0103 ocluzia e cauza principal\u0103 a TMD.<\/p><p>\u00a0<\/p><p>Cu alte cuvinte: din\u021bii conteaz\u0103, ocluzia poate conta \u00eentr-un context clinic anume, dar pacientul cu TMD nu poate fi redus la felul \u00een care se \u00eent\u00e2lnesc dou\u0103 arcade dentare.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e501dbf elementor-widget elementor-widget-heading\" data-id=\"e501dbf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">E o problem\u0103 dentar\u0103 sau medical\u0103?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1aff6a7 elementor-widget elementor-widget-text-editor\" data-id=\"1aff6a7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Poate fi una, cealalt\u0103, sau ambele.\u00a0\u00cemi place s\u0103 v\u0103d ATM nu ca pe o simpl\u0103 balama \u00eentre dou\u0103 oase, ci ca pe o intersec\u021bie. Acolo se \u00eent\u00e2lnesc articula\u021bia, discul, capsula \u0219i ligamentele, musculatura masticatorie, sistemul trigeminal, structurile dentare, regiunea cranio-cervical\u0103, \u0219i mecanismele centrale prin care creierul interpreteaz\u0103 \u0219i moduleaz\u0103 durerea.<\/p><p>\u00a0<\/p><p>La un pacient predomin\u0103 problema articular\u0103. La altul, durerea e predominant miofascial\u0103. Altul are bruxism asociat somnului, cefalee\u00a0sau o durere orofacial\u0103 care trebuie diferen\u021biat\u0103 de o neuropatie. \u0218i, uneori, un pacient are mai multe dintre astea simultan \u2014 motiv pentru care NIDCR descrie TMD ca pe un grup complex de afec\u021biuni, care poate coexista cu migren\u0103, tulbur\u0103ri de somn \u0219i alte forme de durere cronic\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4664d5e elementor-widget elementor-widget-image\" data-id=\"4664d5e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"334\" height=\"282\" src=\"https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/De-ce-nu-putem-spune-e-de-la-muscatura.webp\" class=\"attachment-large size-large wp-image-24107\" alt=\"De ce nu putem spune e de la mu\u0219c\u0103tur\u0103\" srcset=\"https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/De-ce-nu-putem-spune-e-de-la-muscatura.webp 334w, https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/De-ce-nu-putem-spune-e-de-la-muscatura-300x253.webp 300w, https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/De-ce-nu-putem-spune-e-de-la-muscatura-14x12.webp 14w\" sizes=\"(max-width: 360px) 147px, (max-width: 334px) 100vw, 334px\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-09550d6 elementor-widget elementor-widget-heading\" data-id=\"09550d6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">De ce nu putem spune \u201ee de la mu\u0219c\u0103tur\u0103\"\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a72652e elementor-widget elementor-widget-text-editor\" data-id=\"a72652e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Ani de zile s-a presupus c\u0103 o ocluzie imperfect\u0103 e una dintre cauzele principale ale disfunc\u021biilor ATM. De aici au ap\u0103rut \u0219lefuiri dentare, reconstruc\u021bii protetice, modific\u0103ri permanente ale mu\u0219c\u0103turii uneori f\u0103cute tocmai ca s\u0103 \u201etrateze&#8221; simptome ATM.<\/p><p>\u00a0<\/p><p>Datele actuale nu mai sus\u021bin explica\u021bia asta simpl\u0103. NIDCR precizeaz\u0103 clar: cercetarea de azi nu sus\u021bine ideea c\u0103 o \u201emu\u0219c\u0103tur\u0103 incorect\u0103&#8221; sau aparatul ortodontic ar fi, \u00een sine, cauze ale TMD\u00a0\u0219i recomand\u0103 pruden\u021b\u0103 la interven\u021biile care modific\u0103 permanent din\u021bii, ocluzia sau articula\u021bia.\u00a0Asta nu \u00eenseamn\u0103 c\u0103 ignor\u0103m din\u021bii. \u00censeamn\u0103 c\u0103 ocluzia se evalueaz\u0103 \u00een context, al\u0103turi de articula\u021bie, musculatur\u0103, func\u021bia mandibular\u0103, simptome \u0219i restul tabloului clinic. E o diferen\u021b\u0103 important\u0103, nu una cosmetic\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-954b119 elementor-widget elementor-widget-heading\" data-id=\"954b119\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Ce rol are stomatologul\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-196930c elementor-widget elementor-widget-text-editor\" data-id=\"196930c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Unul foarte important. Medicul dentist evalueaz\u0103 structurile dentare, parodon\u021biul, ocluzia, uzura, restaur\u0103rile, edenta\u021biile, tot ce poate produce sau modifica simptomele pacientului. Trebuie excluse \u0219i cauzele odontogene ale durerii: uneori ce pare \u201edurere ATM&#8221; vine de fapt de la un dinte, alteori se \u00eent\u00e2mpl\u0103 exact invers \u2014 pacientul ajunge s\u0103 trateze repetat din\u021bi s\u0103n\u0103to\u0219i pentru o durere care nu are origine dentar\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-640c067 elementor-widget elementor-widget-heading\" data-id=\"640c067\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Ce rol are medicul de Medicin\u0103 Fizic\u0103 \u0219i de Reabilitare\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d770851 elementor-widget elementor-widget-text-editor\" data-id=\"d770851\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Aici e o zon\u0103 pe care cred c\u0103 pacien\u021bii o \u00een\u021beleg cel mai pu\u021bin.\u00a0Sistemul temporo-mandibular e \u0219i un sistem musculo-scheletal \u2014 are articula\u021bie, capsul\u0103, ligamente, mu\u0219chi, control neuromotor, durere, mobilitate, func\u021bie. Astea sunt exact conceptele din Medicina Fizic\u0103 \u0219i de Reabilitare. Evaluarea urm\u0103re\u0219te amplitudinea \u0219i calitatea mi\u0219c\u0103rii mandibulare, durerea articular\u0103 \u0219i muscular\u0103, punctele trigger miofasciale, func\u021bia musculaturii masticatorii \u0219i rela\u021bia cu regiunea cranio-cervical\u0103.<\/p><p>\u00a0<\/p><p>La durerea cronic\u0103, lucrurile se complic\u0103. Durerea nu mai e mereu propor\u021bional\u0103 cu ce vedem \u00een articula\u021bie pot interveni sensibilizarea sistemului nervos, somnul, stresul, comportamentele parafunc\u021bionale. Aici \u00ee\u0219i g\u0103se\u0219te recuperarea medical\u0103 locul \u00een echipa TMD.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f85caca elementor-widget elementor-widget-heading\" data-id=\"f85caca\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Chirurgul oro-maxilo-facial, neurologul, ORL-istul\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9c8502f elementor-widget elementor-widget-text-editor\" data-id=\"9c8502f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Chirurgul e indispensabil c\u00e2nd exist\u0103 patologie structural\u0103 care chiar necesit\u0103 evaluare chirurgical\u0103: traumatisme, anchiloz\u0103, luxa\u021bii recurente, tumori, malforma\u021bii, distruc\u021bie articular\u0103 avansat\u0103. Dar faptul c\u0103 un pacient are durere ATM nu \u00eenseamn\u0103 automat indica\u021bie chirurgical\u0103 \u2014 abordarea contemporan\u0103 recomand\u0103 \u00eenceperea cu metode conservative \u0219i reversibile, iar NIDCR recomand\u0103 pruden\u021b\u0103 fa\u021b\u0103 de interven\u021biile care modific\u0103 permanent articula\u021bia sau ocluzia.<\/p><p>\u00a0<\/p><p>Neurologul \u0219i ORL-istul sunt uneori exact speciali\u0219tii de care e nevoie. Durerea facial\u0103 poate sem\u0103na cu nevralgia de trigemen sau cu alte neuropatii. Cefaleea poate cere diagnostic diferen\u021bial neurologic. Durerea auricular\u0103, presiunea \u00een ureche, tinitusul sau ame\u021beala pot necesita evaluare ORL, ca s\u0103 excludem o patologie otologic\u0103. Un diagnostic bun nu \u00eenseamn\u0103 s\u0103 demonstr\u0103m cu orice pre\u021b c\u0103 toate simptomele vin din ATM \u2014 \u00eenseamn\u0103 \u0219i s\u0103 \u0219tim c\u00e2nd nu vin din ATM.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2420365 elementor-widget elementor-widget-heading\" data-id=\"2420365\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Postura \u0219i coloana cervical\u0103 \u2014 cu grij\u0103 aici\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fb3cfb5 elementor-widget elementor-widget-text-editor\" data-id=\"fb3cfb5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Regiunea cranio-cervical\u0103 \u0219i sistemul masticator au leg\u0103turi anatomice \u0219i neuromusculare reale, iar durerea cervical\u0103 poate coexista cu TMD. Evaluarea func\u021bional\u0103 a coloanei cervicale poate avea sens \u00een anumite cazuri.<\/p><p>\u00a0<\/p><p>Dar asta nu \u00eenseamn\u0103 c\u0103 putem spune simplist c\u0103 \u201epostura proast\u0103 deplaseaz\u0103 mandibula&#8221; sau c\u0103 orice asimetrie postural\u0103 e cauza TMD. La Innovation Medical Center, folosesc evaluarea postural\u0103 ca parte a tabloului func\u021bional, atunci c\u00e2nd simptomele o justific\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-880ab56 elementor-widget elementor-widget-image\" data-id=\"880ab56\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"271\" height=\"340\" src=\"https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/Cum-investighez-ATM.webp\" class=\"attachment-large size-large wp-image-24108\" alt=\"\" srcset=\"https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/Cum-investighez-ATM.webp 271w, https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/Cum-investighez-ATM-239x300.webp 239w, https:\/\/innovationmedical.ro\/wp-content\/uploads\/2026\/08\/Cum-investighez-ATM-10x12.webp 10w\" sizes=\"(max-width: 360px) 147px, (max-width: 271px) 100vw, 271px\" title=\"\">\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-52ee44c elementor-widget elementor-widget-heading\" data-id=\"52ee44c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Cum investighez ATM\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5903ded elementor-widget elementor-widget-text-editor\" data-id=\"5903ded\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Evaluarea \u00eencepe cu anamneza \u0219i examenul clinic: unde doare, c\u00e2nd doare, cum a \u00eenceput, dac\u0103 exist\u0103 blocaje, zgomote articulare, bruxism, cefalee, dureri cervicale, simptome auriculare sau modific\u0103ri ale func\u021biei mandibulare. Urmeaz\u0103 evaluarea mi\u0219c\u0103rilor mandibulare \u0219i a musculaturii, palparea structurilor relevante, examinarea func\u021biei articulare.<\/p><p>\u00a0<\/p><p>Fiecare caz beneficiaz\u0103 de o evaluare multidisciplinar\u0103 astfel ca investiga\u021biile din cabinet sunt vaste, func\u021bionale \u0219i menite s\u0103 integreze toate sistemele care pot genera disfunc\u021bia temporomandibular\u0103. Complet\u0103m cu scanare dentar\u0103 3D \u0219i analiza contactelor ocluzale, evaluarea for\u021bei de mu\u0219c\u0103tur\u0103 \u0219i a asimetriilor func\u021bionale, \u0219i, unde e nevoie, investiga\u021bii imagistice. Ecografia dinamic\u0103 poate da informa\u021bii complementare \u00een anumite situa\u021bii, cu avantajul de a observa structurile \u00een mi\u0219care. Pentru disc \u0219i \u021besuturile moi intraarticulare, RMN-ul r\u0103m\u00e2ne investiga\u021bia de referin\u021b\u0103, iar CBCT\/CT e superior pentru componentele osoase. Importan\u021ba imagisticii ATM a fost reflectat\u0103 \u0219i la congresul european al European Academy of DentoMaxilloFacial Radiology (EADMFR) din 2026, care a inclus sesiuni dedicate corela\u021biilor clinico-radiologice ale leziunilor ATM \u0219i imagisticii moderne a articula\u021biei.<\/p><p>\u00a0<\/p><p>Termografia medical\u0103 o folosesc ca instrument complementar, pentru documentarea unor diferen\u021be de temperatur\u0103 superficial\u0103 \u0219i asimetrii \u2014 este un instrument extrem de valoros \u00een evaluarea func\u021bional\u0103 ATM, dar \u0219i a \u00eentregii posturi.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f3b7d40 elementor-widget elementor-widget-heading\" data-id=\"f3b7d40\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">\u0218i tratamentul urmeaz\u0103 aceea\u0219i logic\u0103\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-475d8d7 elementor-widget elementor-widget-text-editor\" data-id=\"475d8d7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Nu exist\u0103 un singur \u201etratament ATM&#8221;. Un pacient are nevoie predominant de educa\u021bie \u0219i modificarea temporar\u0103 a unor comportamente. Altul beneficiaz\u0103 de recuperare func\u021bional\u0103 \u0219i exerci\u021bii. \u00cen anumite cazuri exist\u0103 indica\u021bie pentru un dispozitiv intraoral, management farmacologic sau terapii complementare. Patologiile structurale severe pot necesita chirurgie.<\/p><p>\u00a0<\/p><p>Fotobiomodularea\u00a0(PBM) este integrat\u0103 \u00een anumite protocoale pentru managementul durerii \u0219i al componentei musculo-scheletale, atunci c\u00e2nd exist\u0103 indica\u021bie \u2014 American Society for Laser Medicine and Surgery (ASLMS) define\u0219te PBM ca utilizarea luminii neionizante pentru efecte fotofizice \u0219i fotochimice, cu men\u021biunea c\u0103 lungimea de und\u0103 \u0219i parametrii de tratament sunt esen\u021biali.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-49c2e4b elementor-widget elementor-widget-heading\" data-id=\"49c2e4b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Multidisciplinar nu \u00eenseamn\u0103 \u201etoat\u0103 lumea trateaz\u0103 tot\"\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-562886e elementor-widget elementor-widget-text-editor\" data-id=\"562886e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Cred c\u0103 asta e ideea central\u0103 a \u00eentregului articol.\u00a0Multidisciplinar nu \u00eenseamn\u0103 s\u0103 trimit automat fiecare pacient la \u0219ase speciali\u0219ti. \u00censeamn\u0103 exact contrariul: s\u0103 identific care specialitate e necesar\u0103 \u00een cazul respectiv. Un pacient predominant muscular are un traseu. Unul cu patologie dentar\u0103 \u0219i ocluzal\u0103 relevant\u0103, altul. Unul cu blocaj articular persistent, altul. Iar un pacient la care suspectez durere neuropat\u0103 are nevoie de neurolog \u00eenaintea oric\u0103rui tratament ATM.<\/p><p>\u00a0<\/p><p>Echipa devine valoroas\u0103 nu c\u00e2nd face c\u00e2t mai multe proceduri, ci c\u00e2nd \u0219tie cine trebuie s\u0103 intervin\u0103 \u2014 \u0219i cine nu.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e2c281d elementor-widget elementor-widget-heading\" data-id=\"e2c281d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Innovation Medical Center \u0219i modelul de lucru\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-02c038d elementor-widget elementor-widget-text-editor\" data-id=\"02c038d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Dezvolt\u0103m evaluarea disfunc\u021biilor ATM \u00eentr-un context interdisciplinar, care leag\u0103 medicina dentar\u0103, evaluarea func\u021bional\u0103, recuperarea medical\u0103, imagistica \u0219i terapiile laser. Centrul are colabor\u0103ri academice cu Sigmund Freud University Vienna \u0219i AALZ \u2013 Aachen Dental Laser Center, iar activitatea \u00een domeniul laserelor dentare e conectat\u0103 la International Society for Laser Dentistry (ISLD).<\/p><p>\u00a0<\/p><p>Pentru pacient, \u00eens\u0103, valoarea colabor\u0103rilor nu se m\u0103soar\u0103 \u00een c\u00e2te tehnologii exist\u0103 \u00eentr-o clinic\u0103. Se m\u0103soar\u0103 \u00een ceva mult mai simplu: s\u0103 prime\u0219ti diagnosticul potrivit \u00eenainte de tratamentul potrivit.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-65ba550 elementor-widget elementor-widget-heading\" data-id=\"65ba550\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Mit sau realitate?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d26121b elementor-widget elementor-widget-text-editor\" data-id=\"d26121b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u00a0\u201eDac\u0103 am ATM, trebuie s\u0103 merg la gnatolog.&#8221; \u2014 Mit, dac\u0103 \u00een\u021belegem prin asta c\u0103 exist\u0103 un singur specialist potrivit pentru toate TMD. Tipul problemei determin\u0103 specialistul sau echipa necesar\u0103.<\/p><p>\u00a0<\/p><p>\u201eProblemele ATM apar pentru c\u0103 mu\u0219c\u0103tura mea nu e corect\u0103.&#8221; \u2014 Mit, ca regul\u0103 general\u0103. Dovezile actuale nu sus\u021bin malocluzia ca explica\u021bie universal\u0103 pentru TMD.<\/p><p>\u00a0<\/p><p>\u00a0\u201eDac\u0103 \u00eemi pocne\u0219te maxilarul, am nevoie de tratament.&#8221; \u2014 Mit. Zgomotele articulare nedureroase sunt frecvente \u0219i, conform NIDCR, \u00een absen\u021ba durerii sau disfunc\u021biei, nu necesit\u0103 automat tratament.<\/p><p>\u00a0<\/p><p>\u00a0\u201eUn RMN poate spune singur dac\u0103 am TMD.&#8221; \u2014 Mit. RMN-ul d\u0103 informa\u021bii anatomice esen\u021biale, mai ales despre disc \u0219i \u021besuturile moi, dar diagnosticul se construie\u0219te prin corelarea simptomelor, examenului clinic \u0219i imagisticii.<\/p><p>\u00a0<\/p><p>\u00a0\u201eO gutier\u0103 rezolv\u0103 orice problem\u0103 ATM.&#8221; \u2014 Mit. Exist\u0103 mai multe diagnostice TMD \u0219i nu toate au aceea\u0219i indica\u021bie terapeutic\u0103.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d75aa28 elementor-widget elementor-widget-heading\" data-id=\"d75aa28\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"> \u00centreb\u0103ri pe care le primesc des\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-79877d1 elementor-widget elementor-widget-text-editor\" data-id=\"79877d1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Exist\u0103 medic gnatolog \u00een Rom\u00e2nia?<\/p><p>\u201eGnatolog&#8221; e un termen folosit \u00een practica dentar\u0103 pentru profesioni\u0219ti preocupa\u021bi de func\u021bia sistemului masticator, dar trebuie diferen\u021biat de o specialitate oficial\u0103. Conteaz\u0103 mai mult formarea profesional\u0103 de baz\u0103, preg\u0103tirea suplimentar\u0103 \u0219i experien\u021ba clinic\u0103 \u00een TMD dec\u00e2t eticheta folosit\u0103 online.<\/p><p>\u00a0<\/p><p>ATM se trateaz\u0103 la dentist sau la medic?**<\/p><p>Depinde de diagnostic. Unele componente \u021bin de medicina dentar\u0103, altele de recuperare medical\u0103, chirurgie, neurologie, ORL sau managementul durerii. Uneori e suficient un singur clinician; alteori e nevoie de colaborare.<\/p><p>\u00a0<\/p><p>Am nevoie de RMN dac\u0103 m\u0103 doare ATM?<\/p><p>Nu \u00eentotdeauna. Indica\u021bia depinde de ce g\u0103sesc la examenul clinic \u0219i de \u00eentrebarea la care imagistica trebuie s\u0103 r\u0103spund\u0103. Pentru disc \u0219i \u021besuturile moi intraarticulare, RMN-ul r\u0103m\u00e2ne investiga\u021bia principal\u0103.<\/p><p>\u00a0<\/p><p>Gutiera trebuie f\u0103cut\u0103 de orice stomatolog?<\/p><p>Realizarea \u0219i monitorizarea unui dispozitiv intraoral pentru TMD presupun stabilirea diagnosticului \u0219i a obiectivului terapeutic \u2014 nu ar trebui prescris\u0103 automat doar pentru c\u0103 pacientul scr\u00e2\u0219ne\u0219te sau \u00eel doare ATM.<\/p><p>\u00a0<\/p><p>De ce m\u0103 trimite medicul ATM \u0219i la neurolog sau ORL?<\/p><p>Pentru c\u0103 durerea facial\u0103, cefaleea, simptomele auriculare \u0219i unele forme de durere neuropat\u0103 se pot suprapune cu TMD, trimiterea c\u0103tre alt specialist nu \u00eenseamn\u0103 c\u0103 primul medic \u201enu \u0219tie ce ai&#8221; \u2014 uneori e exact ce presupune un diagnostic diferen\u021bial corect.<\/p><p>\u00a0<\/p><p>Dac\u0103 m\u0103 doare \u0219i g\u00e2tul, poate avea leg\u0103tur\u0103 cu ATM?<\/p><p>Poate exista asociere \u00eentre simptomele cervicale \u0219i TMD \u0219i regiunea cervical\u0103 merit\u0103 evaluat\u0103 c\u00e2nd tabloul clinic o indic\u0103. Asocierea nu demonstreaz\u0103 \u00eens\u0103 automat c\u0103 una a provocat-o pe cealalt\u0103.<\/p><p>\u00a0<\/p><p><em>Cred c\u0103 r\u0103spunsul modern, p\u00e2n\u0103 la urm\u0103, e acesta: nu exist\u0103 un singur medic pentru toate disfunc\u021biile ATM pentru c\u0103 nu exist\u0103 o singur\u0103 disfunc\u021bie ATM. Sunt pacien\u021bi cu probleme articulare, musculare, dentare, neurologice<\/em><em>\u00a0<\/em><em>sau combina\u021bii \u00eentre ele<\/em><em>, f<\/em><em>orme acute \u0219i forme cronice. Pacien\u021bi care au nevoie de o interven\u021bie simpl\u0103 \u0219i reversibil\u0103 \u0219i pacien\u021bi care au nevoie de investiga\u021bii \u0219i colaborare interdisciplinar\u0103.<\/em><\/p><p>\u00a0<\/p><p><em>Gnatologia<\/em><em> ne-a dat o parte important\u0103 din limbajul prin care \u00een\u021belegem sistemul masticator. Medicina modern\u0103 a ad\u0103ugat ceva esen\u021bial: pacientul e mai complex dec\u00e2t ocluzia lui.<\/em><\/p><p>\u00a0<\/p><p><em>Therefore, <\/em><em><strong>la Innovation Medical Center,<\/strong><\/em><em> \u00eentrebarea nu e doar \u201eunde e problema?&#8221;, ci \u0219i \u201ece mecanism o produce<\/em><em>\u00a0<\/em><em>\u0219i cine e specialistul potrivit pentru acel mecanism?&#8221; Uneori r\u0103spunsul e stomatologul. Alteori, medicul de recuperare. Uneori, neurologul, ORL-istul sau chirurgul. \u00cen cazurile complexe, <\/em><em><strong>r\u0103spunsul e o echip\u0103.<\/strong><\/em><\/p><p>\u00a0<\/p><p><em>Obiectivul nu e s\u0103-i punem pacientului eticheta de \u201eATM&#8221;<\/em><em>, e<\/em><em> s\u0103 afl\u0103m ce are, de ce \u00eel doare<\/em><em>\u00a0<\/em><em>\u0219i ce tratament are, cu adev\u0103rat, sens pentru el.<\/em><\/p><p>\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-74183aa elementor-widget elementor-widget-text-editor\" data-id=\"74183aa\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>\u00a0<\/p><p>Schedule a comprehensive evaluation<\/p><p>\ud83d\udccd Bucure\u0219ti &#8211;\u00a0 www.innovationmedical.ro<\/p><p>\ud83d\udcde 0753 666 111<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dc312f2 elementor-widget elementor-widget-text-editor\" data-id=\"dc312f2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Autor: Dr. Anca Adam, Medic Specialist in Medicina Fizica si de Reabilitare, compartiment recuperare neurologic\u0103 \u0219i disfunc\u021bii ATM\/TMJ, Expert Acupunctur\u0103 Laser &amp; Competenta Medicina Traditionala Chineza (Tai Yuan China), Termografie Medical\u0103 (Barcelona, Spania) &#8211; LSO (Laser Safety Officer) AALZ Aachen Germania.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Ce este gnatologia, de ce ATM se afl\u0103 la grani\u021ba dintre medicin\u0103 \u0219i stomatologie \u0219i de ce diagnosticul modern e adesea multidisciplinar \u201eM\u0103 doare maxilarul. Bun. Dar la ce medic merg?&#8221; Pare o \u00eentrebare simpl\u0103, p\u00e2n\u0103 \u00eencerci s\u0103-i g\u0103se\u0219ti r\u0103spunsul.\u00a0Dac\u0103 te doare un dinte, mergi la stomatolog. Dac\u0103 te doare genunchiul, te g\u00e2nde\u0219ti la ortoped [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":24102,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30],"tags":[],"class_list":["post-24101","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articulatia-temporo-mandibulara-atm"],"_links":{"self":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/24101","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/comments?post=24101"}],"version-history":[{"count":4,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/24101\/revisions"}],"predecessor-version":[{"id":24111,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/posts\/24101\/revisions\/24111"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/media\/24102"}],"wp:attachment":[{"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/media?parent=24101"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/categories?post=24101"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/innovationmedical.ro\/en\/wp-json\/wp\/v2\/tags?post=24101"}],"curies":[{"name":"WordPress","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}