Uncommon Posterior Disc Displacement of Temporomandibular Joint - A Case Report.

Rationale: Posterior disc displacement (PDD) is an uncommon condition in which disc tissue is located between the posterior surface of the condyle and post-glenoid tubercle. The etiopathogenesis of this condition is idiopathic. There are different predisposing factors in the literature which are consistent with the presented case such as lack of anterior prominence of the disc, thinning of the posterior zone of the disc and perforation of the disc. Patient Concerns: We report an uncommon temporomandibular joint (TMJ) arthropathy case of a 33-year-old female patient, who presented with long-standing TMJ pain associated with limited mouth opening. Diagnosis: The patient was diagnosed with non-reducible PDD of TMJ bilaterally. Treatment: Open surgery of TMJ (Discopexy) was the choice of treatment to release and mobilise discs. Outcomes: A noticeable increase in mouth opening without pain in TMJ area was achieved immediately after surgery and remained stable during periodic follow-ups. Take-away Lessons: The importance of magnetic resonance imaging as a diagnostic tool for arthropathy, to determine the proper management is essential. Moreover, the root of the helix inter tragus notch incision presents an advantage of open surgery of TMJ which results in immediate outcome with limited complications.

Posterior disc displacement of the temporomandibular joint: A rare case report.

BACKGROUND: Posterior disc displacement (PDD) of the temporomandibular joint (TMJ) is quite rare. The normal position of a disc is slightly anterior to the condyle, so the chances of disc displacement to the posterior direction are low. CASE PRESENTATION: A 71-year-old Japanese female reported with a chief complaint of lack of occlusion on the right-side molar teeth. Clinical examination revealed lack of occlusal contact in the right posterior region, nearly normal range of mouth opening (41.0 mm), masseter muscle tenderness, and deviation to the left on opening. MRI of the right TMJ showed PDD in both the open- and closed-mouth position and joint effusion. Conservative treatment with a non-steroidal anti-inflammatory drug, stretch exercise with fingers, and stabilization splint improved symptoms for 9 months. CONCLUSION: Conservative treatment was effective in managing the patient. A follow-up for 9 months with a repeat MRI was undertaken to monitor the progress.

Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management.

Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care.

Two cases of posterior open bite caused by the thickness of retrodiscal tissue in the temporomandibular joint.

There have been few reports of mouth closing disturbances in the final phase of occlusion caused by the posterior thickness of the retrodiscal tissue. Two such cases are described here. The first was a 70-year-old female suffering from a painless mouth closing disturbance on the right side of the temporomandibular joint (TMJ). She complained of a feeling like there was an air cushion. The second case was a 51-year-old male with a painless mouth closing disturbance on the left side of the TMJ. In both cases, magnetic resonance imaging (MRI) revealed enlargement of the posterior joint space on the affected side. The conditions of these two cases were improved by local injection of steroid preparations; however further additional treatments were required, including mandible traction in one case and dental prosthetics in the other. Consequently, we consider that the local injection of steroid preparations is useful as an initial treatment, while the use of local injection of steroid preparations alone is not sufficient for the treatment of posterior thickness of the retrodiscal tissue.