hrvatski

Kronična bol kod poremećaja temporomandibularnoga zgloba – orofacijalnom traumom uzrokovana remisija simptoma

Temporomandibular disorders are a group of musculoskeletal disorders accompanied by pain in masticatory muscles and/or temporomandibular joints. They are of unknown etiology and the possible etiological factors can be of different importance for certain patients. TMJ disorder can be an anterior articular disc displacement (discopathy) and/or articular arthrosis. The case described is of a female patient who initially suffered from pain and clicking in both temporomandibular joints and after some time only in the right joint which started two years ago. Six months later she visited the prosthodontist due to unsuccessful initial treatment by an oral surgeon (AVS=7). The occlusal splint she was wearing at the time was replaced by a new one which ensured the stability of joints and teeth occlusion. Discopathy in both joints was diagnosed by magnetic resonance imagining. Although she felt better, the follow-up magnetic resonance images did not show a significant reduction of anterior articular disc displacement. However, two years later the patient suffered a traffic accident. She experienced pain remission in her right temporomandibular joint together with polytrauma (brain commotion, nose, leg and rib fracture as well as a whiplash neck injury). She immediately received two block injections due to swelling and after that she visited a dentist. She continued wearing the splint but without improvement. A year later she still suffers from strong pain (AVS=8.5) with limited mouth opening but the pain is now more expressed in the left joint. The chronification of temporomandibular pain can be explained by an increased anxiety level in the period starting with the first visit (STAI according to Spielberger (2004/2007): STAI 1=31/64 and STAI 2=31/58) and the functional status cannot be explained by MRI of the joints which remained the same. The unsuccessful initial treatment can be attributed to irregular pharmacotherapy accompanied by stomach pain, lack of physical therapy facilities in the area and the impossibility of wearing the splint due to its breaking. Treatment of chronic musculoskeletal pain requires a multidisciplinary cooperation of medical and dental specialists together with the patient’ s active participation in the planning and course of initial treatment.

temporomandibularni poremećaji; pomak zglobne pločice; magnetska rezonancija; kronična bol

nije evidentirano

engleski

Chronic pain in temporomandibular joint disorders – symptoms’ remission caused by orofacial trauma

Temporomandibular disorders are a group of musculoskeletal disorders accompanied by pain in masticatory muscles and/or temporomandibular joints. They are of unknown etiology and the possible etiological factors can be of different importance for certain patients. TMJ disorder can be an anterior articular disc displacement (discopathy) and/or articular arthrosis. The case described is of a female patient who initially suffered from pain and clicking in both temporomandibular joints and after some time only in the right joint which started two years ago. Six months later she visited the prosthodontist due to unsuccessful initial treatment by an oral surgeon (AVS=7). The occlusal splint she was wearing at the time was replaced by a new one which ensured the stability of joints and teeth occlusion. Discopathy in both joints was diagnosed by magnetic resonance imagining. Although she felt better, the follow-up magnetic resonance images did not show a significant reduction of anterior articular disc displacement. However, two years later the patient suffered a traffic accident. She experienced pain remission in her right temporomandibular joint together with polytrauma (brain commotion, nose, leg and rib fracture as well as a whiplash neck injury). She immediately received two block injections due to swelling and after that she visited a dentist. She continued wearing the splint but without improvement. A year later she still suffers from strong pain (AVS=8.5) with limited mouth opening but the pain is now more expressed in the left joint. The chronification of temporomandibular pain can be explained by an increased anxiety level in the period starting with the first visit (STAI according to Spielberger (2004/2007): STAI 1=31/64 and STAI 2=31/58) and the functional status cannot be explained by MRI of the joints which remained the same. The unsuccessful initial treatment can be attributed to irregular pharmacotherapy accompanied by stomach pain, lack of physical therapy facilities in the area and the impossibility of wearing the splint due to its breaking. Treatment of chronic musculoskeletal pain requires a multidisciplinary cooperation of medical and dental specialists together with the patient’ s active participation in the planning and course of initial treatment.

temporomandibular disorders; disc displacement; magnetic resonance imaging; chronic pain

nije evidentirano