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Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report.

Camino Junior R, Manzi MR, Carvalho MF, Luz JG, Pimentel AC, Deboni MC - Dental Press J Orthod (2015)

Bottom Line: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex.With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening.By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

View Article: PubMed Central - PubMed

Affiliation: Universidade de São Paulo, São Paulo, São Paulo, Brazil.

ABSTRACT

Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening.

Case report: The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch) with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders.

Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

No MeSH data available.


Related in: MedlinePlus

- A) MRI sagittal slice of the right TMJ with the mouth closed, evincingthe persistence of TMJ articular disc displacement. B) MRI sagittal slice ofthe right TMJ at maximal mouth opening, evincing reduction of TMJ articulardisc.
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f08: - A) MRI sagittal slice of the right TMJ with the mouth closed, evincingthe persistence of TMJ articular disc displacement. B) MRI sagittal slice ofthe right TMJ at maximal mouth opening, evincing reduction of TMJ articulardisc.

Mentions: The patient received a prescription of anti-inflammatory drugs (100 mg of nimesulide,12/12 hours, orally) during five days, and also was advised not to force mandibularmovements after reduction. The patient was instructed to use a stabilizer plateimmediately after correct manipulation, so as to avoid a new disc displacement andreduce muscle hyperactivity. There were no complications after the manipulationmaneuver, and an immediate 40-mm mouth opening was achieved after manual manipulation(Figs 7A, B). The patient was followed-up on aweekly basis in the first month and every two weeks until the third month, showing noepisodes of TMD within this period. Figures 8A and8B show MRI sagittal slices of the right TMJwith closed mouth presenting disc displacement and in maximum mouth opening movement,evincing reduction of TMJ articular disc.


Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report.

Camino Junior R, Manzi MR, Carvalho MF, Luz JG, Pimentel AC, Deboni MC - Dental Press J Orthod (2015)

- A) MRI sagittal slice of the right TMJ with the mouth closed, evincingthe persistence of TMJ articular disc displacement. B) MRI sagittal slice ofthe right TMJ at maximal mouth opening, evincing reduction of TMJ articulardisc.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644926&req=5

f08: - A) MRI sagittal slice of the right TMJ with the mouth closed, evincingthe persistence of TMJ articular disc displacement. B) MRI sagittal slice ofthe right TMJ at maximal mouth opening, evincing reduction of TMJ articulardisc.
Mentions: The patient received a prescription of anti-inflammatory drugs (100 mg of nimesulide,12/12 hours, orally) during five days, and also was advised not to force mandibularmovements after reduction. The patient was instructed to use a stabilizer plateimmediately after correct manipulation, so as to avoid a new disc displacement andreduce muscle hyperactivity. There were no complications after the manipulationmaneuver, and an immediate 40-mm mouth opening was achieved after manual manipulation(Figs 7A, B). The patient was followed-up on aweekly basis in the first month and every two weeks until the third month, showing noepisodes of TMD within this period. Figures 8A and8B show MRI sagittal slices of the right TMJwith closed mouth presenting disc displacement and in maximum mouth opening movement,evincing reduction of TMJ articular disc.

Bottom Line: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex.With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening.By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

View Article: PubMed Central - PubMed

Affiliation: Universidade de São Paulo, São Paulo, São Paulo, Brazil.

ABSTRACT

Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening.

Case report: The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch) with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders.

Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements.

No MeSH data available.


Related in: MedlinePlus