牙切除后颞下颌关节创伤的治疗

Intan Ruspita, H. Dipoyono
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摘要

颞下颌关节紊乱(TMD)是一种非牙齿肌肉骨骼紊乱,具有复杂的多因素病因。最常见的症状是咀嚼肌疼痛、耳前疼痛和颞下颌关节疼痛;这种障碍也可能伴随着咔哒声和锁定声。本研究的目的是提出一个病例报告的颞下颌关节创伤后,牙切除。一名22岁的患者出现了一些症状,即颞下颌关节疼痛、张嘴和闭口时发出咔嗒声、张嘴受限。患者在进行了全部四颗第三磨牙的牙齿切除手术后,出现了下颌周围紧绷、疼痛和咔嗒声。然而,她没有寻求任何治疗,直到疼痛变得更严重,并干扰了她的活动。病人不得不处理有限的张嘴和严重的偏头痛,每天两次。在一次检查中,患者能够无痛地张开她的嘴,宽度只有25毫米,最大开口为35毫米。治疗是通过构建一个4毫米稳定夹板和教育患者如何减轻疼痛来完成的。事实上,在治疗和使用稳定夹板2个月后,她对TMJ疼痛和咔嗒声的抱怨减少了,她的张嘴增加了,偏头痛再也没有复发。在这种情况下,无创治疗作为椎间盘移位伴复位和关节痛患者的一线治疗方法,可减轻关节疼痛症状,部分症状甚至消失。
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Treatment of temporomandibular joint trauma following odontectomy
Temporomandibular Joint Disorder (TMD) is a non-dental musculoskeletal disorder that has a complex and multifactorial etiology. The most frequent symptoms are pain in the masticatory muscles, in front of the ears, and in the temporomandibular joint (TMJ); this disorder can also be accompanied by clicking sounds and locking. This study aimed to present a case report of temporomandibular joint trauma following odontectomy. A 22-year-old patient came with some complaints, namely pain in the TMJ, a clicking sound when opening and closing the mouth, and limited mouth opening. The symptoms started when the patient underwent odontectomy on all the four third molars, causing tightness around the jaw, pain, and clicking. However, she did not seek any treatment for these conditions until the pain became worse and disturbed her activities. The patient had to deal with limited mouth opening and severe migraines up to twice a day. During an examination, the patient was able to open her mouth without pain only 25 mm in width, with a maximum mouth opening of 35 mm. The therapy was done by constructing a 4-mm stabilization splint and educating the patient on how to reduce the pain. In fact, 2 months after the treatment and the use of stabilization splints, her complaints of TMJ pain and clicking sounds decreased, her mouth opening increased, and the migraines never came back. In this case, non-invasive treatment as the first-line therapy in patients with disc displacement with reduction and arthralgia can reduce the joint pain symptoms, and some of the symptoms have even disappeared.
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