Total bilateral TMJ reconstruction for pain and dysfunction: Case report

• Published in: International journal of surgery case reports Vol. 42; pp. 138 - 144
• Main Authors: Moreira, Carlos Vinícius Ayres, Serra, André Victor Pinto, Silva, Larissa Oliveira Ramos, Fernandes, Ana Carolina Fraga, de Azevedo, Roberto Almeida
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier 01-01-2018
• Subjects: Joint prostheses; Temporomandibular joint; Temporomandibular joint disorders
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2017.11.063

Temporomandibular disorders encompass a set of clinical conditions that affect the temporomandibular joint, the masticatory muscles and the associated tissues. Many therapeutic alternatives can be considered, being divided into non-invasive, minimally invasive and invasive interventions. This work aims to report a case of inflammatory joint pain and dysfunction treated with bilateral TMJ full reconstruction with alloplastic prosthesis stock.
Patient D.J.S.S., female, 41 years old, hypertensive, for six years had constant pain in TMJ bilaterally, with limitation of mouth opening, with a clinical signs of joint disc displacement without reduction. Initially treated only by conservative approaches. Without improvement, arthrocentesis of the TMJ was performed. The symptoms do not regress, leading the patient to bilateral discopexy procedure. We opted for the alloplastic substitution of the temporomandibular joint with prostheses of stock in both joints through an established protocol.
The main objective of the reconstruction of the temporomandibular joint in cases of joint bone degeneration is the restoration of form and function, considering the reduction of pain as a secondary result. Alloplastic replacement of TMJ can be considered as an alternative therapy to improve the quality of life of a small group of patients showing signs and symptoms of TMD as a reduction of maximum mouth opening, pain, etc.
The use of total joint prostheses has been configured as a good therapeutic alternative for severe conditions of TMJ that do not respond to conservative treatments. However, further studies are needed to demonstrate whether these results are long term.