Assoc. prof. dr Mijoska Aneta

Assoc. prof. dr Mijoska Aneta

Assist. Prof. dr Petkov Marjan

MANAGEMENT OF PAIN IN PATIENTS WITH TEMPOROMANDIBULAR DISORDER (TMD): CHALLENGES AND SOLUTIONS

Temporomandibular disorders (TMD) comprise a variety of conditions affecting the anatomy and functional characteristics of the temporomandibular joint, masticatory muscles and surrounding structures. Common factors contributing to TMD are related to occlusion, trauma, anxiety and behavioral causes that frequently provoke symptoms of muscular, articular, and periarticular pain. Orofacial pain is defined as pain manifested in the face or oral cavity, including disorders as TMD that are major cause of non-odontogenic chronic pain. TMD has considerable prevalence, with a significant impact on physical and psychosocial wellbeing. Its prevalence has been reported to be between 3.7% and 12% and is three to five times more frequent in women. The so-called parafunctional behavior and conditions such as bruxism are some of the most important causes of TMD. By far, muscular dysfunction or hyperactivity is the most frequent cause of TMD. Treating the dysfunction can be particularly challenging, and a suitable therapeutic approach should be aimed at alleviating the main signs and symptoms of this condition. The vast majority of TMD symptoms subside spontaneously, and a large proportion of patients respond to conservative therapy.

When injected into a muscle Botulinum toxin-type A (BoNT) blocks the release of acetylcholine - neurotransmitter that induces muscle contraction, blocks exocytosis and reduces the ability of the muscle to contract. Despite the limited research on chronic orofacial pain, the preliminary reports of efficacy are promising and offer the potential to improve pain relief in patient’s refractory to conventional treatments. However, BoNT should only be used when those therapies have failed. The global approach to TMD and bruxism should be multidisciplinary.

Associate professor dr. Aneta Mijoska
Graduated from the Faculty of Dentistry UKIM, North Macedonia in 1997. From 2002-2007 worked as a dentist in еmergency department at USKC Sveti Panteleimon in Skopje. Since 2007, she has been working at the Clinic for Fixed Dental Prosthetics, where she became a specialist in dental prosthetics in 2011. In 2009, she was elected an assistant at the Department of Dental Prosthetics at the Faculty of Dentistry in Skopje. In 2015, she received her doctorate in the field of zirconium dioxide ceramics - mechanical characteristics and adhesion properties. In 2022, she became an associate professor. Field of research: all-ceramic, occlusion and gnathology, T-scan analyses, Velscope-non-invasive technique for examining oral tissues and precancerous changes, gerontostomatology, etc. Participant of several domestic and international projects (Faculty of Medicine - Ljubljana, Slovenia). She is the author and co-author of 3 professional books in thе field and a pre-clinical practicum for faculty teaching. Author and co-author of over 65 scientific and professional papers in this field, regular active participant of European, world and domestic congresses and conferences. Prof. Mijoska also performed as an invited lecturer at congresses in North Macedonia and abroad (3rd Congress of Dentists of Montenegro 2019, 19th and 21st Congress of Dentists of Serbia 2019, 2022, 2022 UBT Prishtina; Kosovo). She expresses his professional work as a member of the editorial board of the scientific and professional journal Knowledge - International Journal, indexed in several international databases and as a reviewer in several SCI journals. 2014-2018 vice president of the Supervisory Commission of the Dental Chamber of North Macedonia. 2009 and 2019 - Certificate of appreciation for participation in the work and development of the Faculty of Dentistry on the occasion of marking the 50th and 60th years of the Faculty of Dentistry in Skopje.