{"title":"骨关节炎颞下颌关节闭锁自我护理后重建椎间盘-髁状突-下颌窝对齐和髁状突修复:病例报告","authors":"","doi":"10.1016/j.ajoms.2024.04.001","DOIUrl":null,"url":null,"abstract":"<div><p>Temporomandibular joint (TMJ) disc displacement without reduction, often referred to as closed lock, is a debilitating condition characterized by a sudden decrease in mouth opening capacity, accompanied by TMJ pain<span>. Over time, this closed lock can lead to the development of TMJ<span><span> osteoarthritis (OA). While conservative treatments effectively alleviate TMJ pain and improve jaw function in most patients, they seldom restore normal TMJ structures. In this case report, we present a rare case of a 39-year-old woman who experienced the restoration of a normal disc-condyle-mandibular fossa relationship and the repair of OA changes following self-care for chronic TMJ closed lock with OA. She initially presented with a 7-month history of left TMJ pain and limited mouth opening persisting. Magnetic resonance imaging (MRI) of the left TMJ showed anterior disc displacement without reduction and OA changes including erosion, subchondral cyst, and </span>sclerosis of the subchondral bone in the left condyle. Self-care, including parafunction control and stretching exercises, relieved the TMJ pain and increased the range of mouth opening. A follow-up MRI obtained 13 months following the initial MRI revealed a normal disc-condyle-mandibular fossa relationship and repair of the surface erosion with the subchondral cyst. Our clinical findings indicate that although rare, restoration of the normal disc-condyle-mandibular fossa relationship and condylar repair are possible through self-care for chronic closed lock with OA.</span></span></p></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reestablishing disc-condyle-mandibular fossa alignment and condylar repair following self-care for the temporomandibular joint closed lock with osteoarthritis: A case report\",\"authors\":\"\",\"doi\":\"10.1016/j.ajoms.2024.04.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Temporomandibular joint (TMJ) disc displacement without reduction, often referred to as closed lock, is a debilitating condition characterized by a sudden decrease in mouth opening capacity, accompanied by TMJ pain<span>. Over time, this closed lock can lead to the development of TMJ<span><span> osteoarthritis (OA). While conservative treatments effectively alleviate TMJ pain and improve jaw function in most patients, they seldom restore normal TMJ structures. In this case report, we present a rare case of a 39-year-old woman who experienced the restoration of a normal disc-condyle-mandibular fossa relationship and the repair of OA changes following self-care for chronic TMJ closed lock with OA. She initially presented with a 7-month history of left TMJ pain and limited mouth opening persisting. Magnetic resonance imaging (MRI) of the left TMJ showed anterior disc displacement without reduction and OA changes including erosion, subchondral cyst, and </span>sclerosis of the subchondral bone in the left condyle. Self-care, including parafunction control and stretching exercises, relieved the TMJ pain and increased the range of mouth opening. A follow-up MRI obtained 13 months following the initial MRI revealed a normal disc-condyle-mandibular fossa relationship and repair of the surface erosion with the subchondral cyst. Our clinical findings indicate that although rare, restoration of the normal disc-condyle-mandibular fossa relationship and condylar repair are possible through self-care for chronic closed lock with OA.</span></span></p></div>\",\"PeriodicalId\":45034,\"journal\":{\"name\":\"Journal of Oral and Maxillofacial Surgery Medicine and Pathology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-04-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Oral and Maxillofacial Surgery Medicine and Pathology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2212555824000553\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212555824000553","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
颞下颌关节(TMJ)椎间盘移位而不缩小,通常被称为闭锁,是一种使人衰弱的病症,其特点是张口能力突然下降,并伴有颞下颌关节疼痛。随着时间的推移,闭锁可导致颞下颌关节骨关节炎(OA)的发展。虽然保守治疗能有效缓解大多数患者的颞下颌关节疼痛并改善下颌功能,但很少能恢复正常的颞下颌关节结构。在本病例报告中,我们介绍了一例罕见的病例,患者是一名 39 岁的女性,她在对伴有 OA 的慢性颞下颌关节闭锁进行自我护理后,椎间盘-髁状突-下颌窝关系恢复正常,OA 病变也得到修复。她最初因左侧颞下颌关节疼痛和张口受限持续 7 个月而就诊。左侧颞下颌关节的磁共振成像(MRI)显示椎间盘前移位,但未缩小,OA 病变包括侵蚀、软骨下囊肿和左侧髁突软骨下骨硬化。包括副功能控制和伸展运动在内的自我护理缓解了颞下颌关节疼痛,并增加了张口范围。在初次核磁共振成像检查后 13 个月进行的后续核磁共振成像检查显示,椎间盘-髁状突-下颌窝关系正常,软骨下囊肿的表面侵蚀得到修复。我们的临床研究结果表明,对于患有 OA 的慢性闭锁患者来说,通过自我护理恢复正常的椎间盘-髁突-下颌窝关系和髁突修复是可能的,尽管这种情况很少见。
Reestablishing disc-condyle-mandibular fossa alignment and condylar repair following self-care for the temporomandibular joint closed lock with osteoarthritis: A case report
Temporomandibular joint (TMJ) disc displacement without reduction, often referred to as closed lock, is a debilitating condition characterized by a sudden decrease in mouth opening capacity, accompanied by TMJ pain. Over time, this closed lock can lead to the development of TMJ osteoarthritis (OA). While conservative treatments effectively alleviate TMJ pain and improve jaw function in most patients, they seldom restore normal TMJ structures. In this case report, we present a rare case of a 39-year-old woman who experienced the restoration of a normal disc-condyle-mandibular fossa relationship and the repair of OA changes following self-care for chronic TMJ closed lock with OA. She initially presented with a 7-month history of left TMJ pain and limited mouth opening persisting. Magnetic resonance imaging (MRI) of the left TMJ showed anterior disc displacement without reduction and OA changes including erosion, subchondral cyst, and sclerosis of the subchondral bone in the left condyle. Self-care, including parafunction control and stretching exercises, relieved the TMJ pain and increased the range of mouth opening. A follow-up MRI obtained 13 months following the initial MRI revealed a normal disc-condyle-mandibular fossa relationship and repair of the surface erosion with the subchondral cyst. Our clinical findings indicate that although rare, restoration of the normal disc-condyle-mandibular fossa relationship and condylar repair are possible through self-care for chronic closed lock with OA.