Fractures are one of the most common components in multiple and associated injuries. Fractures of the lower jaw are observed in 76%, of the upper jaw in 24%, a fracture of the zygomatic-orbital complex in 12%. The actual problem of modern traumatology is the violation of reparative osteogenesis with injuries combined with facial trauma. The duration of the consolidation of fractures is determined by the degree of microcirculation disorders in the fracture zone, changes in cellular and coagulation hemostasis and mineral metabolism. In this connection, increasing the effectiveness of treatment of fractures of the bones of the face on the basis of early diagnosis of vascular and hemostasiological changes is of great importance for practical health care.
Axiography is an objective method of examining the trajectory of the articular pathway, which allows us to assess the nature of the function in normal and functional disorders of the temporomandibular joint.To carry out the method of axiography, an Arcus digma axiograph (KaVo, Germany) was used, which was connected to a personal computer. Arcus digma (KaVo, Germany) is an electronic system for recording movements of the lower jaw, which allows for three-dimensional ultrasonic recording of movements of the lower jaw and registering angles to adjust the articulator to an individual function. An ultrasonic transmitter and a receiver mounted on a measuring arc were connected to the main device of the device. Data was saved directly during measurements on a connected computer, and the selection of workspaces and workflow management were carried out through the main device or using a pedal. The holder of the paraocclusive plug, which was fixed using Structur 2 SC (VOCO) to the vestibular surface of the teeth of the lower jaw, was connected to the transmitter. The selection of the required measuring program was carried out from the touch screen of the basic device. If necessary, all the measurements carried out could be reproduced in dynamic mode many times. All movements were performed while maintaining contact between the teeth of the upper and lower jaw. In this study, we used the proposed method of combined use of the Littmann electronic stethoscope and the Arcus digma axiograph (Fig.5) (innovation proposal No. 1600 dated 11.02.2016, authors: Geletin P.N., Morozov V.G., Mishutin E.A., Ginali N.V., Karelina A.N.). the combined application of axiography and auscultation of the temporomandibular joint is as follows:
8. The diagnosis was made based on the analysis of axigrams (deviation of the trajectories of opening and closing the mouth from the norm in the sections of the axiogram corresponding to the initial, middle and final phase of opening and closing the mouth and computer analysis of phonogram recordings according to the main characteristics of sound (sound strength and frequency) and the phase of opening and closing the mouth, in which sound phenomena occur.