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http://dx.doi.org/10.14476/jomp.2012.37.4.205

Acute Occlusal Change Following Acute Anterior Disc Displacement without Reduction: A Case Report  

Jung, Jae-Kwang (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
Hur, Yun-Kyung (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
Choi, Jae-Kap (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
Publication Information
Journal of Oral Medicine and Pain / v.37, no.4, 2012 , pp. 205-211 More about this Journal
Abstract
A 35 year-old female presented with the complaint of sudden occurrence of bite change and concurrent opening limitation, as well as pain in the right temporomandibular joint (TMJ) during mouth opening. From her history it was revealed that she had simple clicking of right TMJ for several years before onset of these symptoms, and that the clicking sound subsided recently after development of opening limitation. On clinical examination, anterior open bite, midline shift of the mandible to right, and premature contacts on left posterior teeth were observed. Maximum mouth opening and lateral movement to left were also restricted. On magnetic resonance images, the right TMJ showed anterior disc displacement without reduction and the posterior joint space is greatly collapsed by retrusion of the condyle. It was thought that the sudden occurrence of occlusal change would be resulted from abrupt displacement of the mandible associated with development of the anterior disc displacement without reduction. The stabilization appliance traction therapy was performed initially for first 3 months along with physical and pharmacologic therapy. However, the anterior open bite and opening limitation didn't resolve and the position of mandible still remained altered. So the stabilization appliance was changed to intermaxillary traction device. Then the mandible returned progressively to normal position and the occlusion became more stable and comfortable. After 5 months of intermaxillary traction therapy, the anterior open bite was dissolved completely and the occlusion became stabilized satisfactorily along with recovery of normal mouth opening range. On post-treatment magnetic resonance image, remodeling of condylar head was observed.
Keywords
Acute occlusal change; Anterior disc displacement; Intermaxillary traction therapy; Magnetic resonance image;
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