ADÍLIA
LEARN ABOUT THE CASE OF ADÍLIA MARQUES
CLINICAL CASE OF TEMPOROMANDIBULAR DISORDER
SUMMARY OF PATIENT HISTORY
About 3 years ago she started to feel pain in her left hemiface and ears. She was observed by Otorhinolaryngology without changes. Due to continuous pain, she was observed by Neurology where she was diagnosed with trigeminal neuralgia. Cranial magnetic resonance imaging (MRI) revealed compression of the trigeminal nerve, and the patient underwent surgical decompression; initially she improved but it recurred 6 months later. Craniomaxillofacial (CMF)observation was conducted, and she carried out did 2 Botox sessions without improvement. She was then observed by another CMF unit, that performed arthrocentesis of the left temporomandibular joint (TMJ), again without improvement. She was observed by dentistry, made 6 dental extractions without improvement.
MAIN COMPLAINTS
> Throbbing pain all day in the left temporomandibular joint (TMJ) area
> Could not eat or chew
> When opening her mouth slightly, it worsens
> RIGHT TMJ pain (7/10 on visual-analogue scale (VAS))
> LEFT TMJ pain (10/10)
> Refers to bilateral clicking, more accentuated on the left
SUMMARY OF THE OBJECTIVE EXAMINATION
> Limited maximum mouth opening (21mm)
> Severe pain on palpation of the TMJs
> Bilateral clicking
> Grade 3 muscle contracture
DIAGNOSIS
RIGHT TMJ:
> ANTERIOR DISC DISPLACEMENT WITH NO REDUCTION, TMJ OSTEOARTHROSIS
LEFT TMJ:
> ANTERIOR DISC DISPLACEMENT WITH NO REDUCTION, TMJ OSTEOARTHROSIS
> GRADE 3 MUSCLE CONTRACTURE
TREATMENT
> BILATERAL OPEN DISC REPOSITIONING SURGERY
> BOTOX PROTOCOL
> COGNITIVE COACHING
> 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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" I HAVE A NEW LIFE WITH MUCH MORE QUALITY OF LIFE. "
Adília Marques
TEAM IN CHARGE
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