ANA
LEARN ABOUT THE CASE OF ANA COSTA
CLINICAL CASE OF TEMPOROMANDIBULAR DISORDER
SUMMARY OF PATIENT HISTORY
Extraction of central incisors when she was 16 years old. Superior all-on-6 with immediate loading 3 years ago when she started to hear asymptomatic joint sounds. A year ago, following oral rehabilitation, she began to experience painful clicks, first starting with right clicks that evolved to include clicks on the left. A new prosthesis was placed with partial improvement. She wore a splint for 3 months without improvement. In the past 6 months, this progressed to more pain and limited mouth movement. The daughter, a Medical Doctor, ordered an MRI.
MAIN COMPLAINTS
> Difficulty in chewing
> Progressively limited mouth opening
> RIGHT TMJ pain (8/10 - VAS)
> LEFT TMJ pain (8/10 - VAS)
> Muscle tension in the face
SUMMARY OF THE OBJECTIVE EXAMINATION
> Limited maximum mouth opening (19mm)
> Severe pain on palpation of the TMJs
> Bilateral clicking > Grade 2 muscle contracture
> No intraoral changes
DIAGNOSIS
RIGHT TMJ:
> ANTERIOR DISC DISPLACEMENT WITHOUT REDUCTION, TMJ OSTEOARTHROSIS
LEFT TMJ:
> ANTERIOR DISC DISPLACEMENT WITHOUT REDUCTION, TMJ OSTEOARTHROSIS
> GRADE 2 MUSCLE CONTRACTURE
TREATMENT
> BILATERAL OPEN DISC REPOSITIONING SURGERY
> BOTOX PROTOCOL
> STOMATOGNATHIC SYSTEM REHABILITATION
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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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" SURGERY TO TREAT MY JAW
DISORDER HAS CHANGED
EVERYTHING, NOW I FEEL GOOD. "
Ana Costa
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