Clinical Case of Temporomandibular Dysfunction
SUMMARY OF THE PATIENT'S HISTORY
About a year ago, there were several episodes of blockages in the ATM, more localized on the right side. The blockages were more intense during chewing and associated with pain. A mouthguard was recommended by dental medicine, but the patient could not tolerate it. She feels an increase in clicking sounds. She denies limitation in mouth opening. She denies difficulty in chewing.
MAIN COMPLAINTS
> Estalidos das ATM
> Bloqueios das ATM
> Dor ATM direita 5/10 VAS
> Dor ATM esquerda 4/10 VAS
SUMMARY OF THE OBJECTIVE EXAM
> TMJ of 43mm
> Right TMJ: Grade 3 synovitis with suspicion of disc displacement without reduction
> Left TMJ: Grade 1 synovitis with suspicion of disc displacement with reduction
> Muscle contracture grade 3
DIAGNOSIS
RIGHT ATM Header
Anterior displacement of the disc without reduction with joint effusion.
LEFT ATM:
Here’s the translation of the paragraph to English:
"Anterior displacement of the disc without reduction, perforation of the disc + osteoarthritis of the TMJ.
Muscle contracture grade 2."
TREATMENT
> OPEN LEFT TMJ SURGERY - DISCECTOMY AND REGENERATION
> ARTHROSCOPY OF THE RIGHT TMJ - LEVEL 2
> BOTOX PROTOCOL
> STOMATOGNATHIC SYSTEM REHABILITATION
BEFORE AND AFTER
EVOLUTION OF PAIN IN THE LEFT AND RIGHT TEMPOROMANDIBULAR JOINT
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EVOLUTION OF MOUTH OPENING
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"NOW I CAN EAT WHAT I FEEL LIKE."
Beatriz Abreu
RESPONSIBLE TEAM
SEE OTHER CLINICAL CASES OF TEMPOROMANDIBULAR DYSFUNCTION
