Testemunho - Adília Marques
 
 
 

Adília

 
LEARN ABOUT THE CASE OF ADÍLIA MARQUES
 
 
 
 
 

CLINICAL CASE OF TEMPOROMANDIBULAR DISORDER

 
 

SUMMARY OF PATIENT HISTORY

 
About 3 years ago she started to feel pain in her left hemiface and ears. She was observed by Otorhinolaryngology without changes. Due to continuous pain, she was observed by Neurology where she was diagnosed with trigeminal neuralgia. Cranial magnetic resonance imaging (MRI) revealed compression of the trigeminal nerve, and the patient underwent surgical decompression; initially she improved but it recurred 6 months later. Craniomaxillofacial (CMF)observation was conducted, and she carried out did 2 Botox sessions without improvement. She was then observed by another CMF unit, that performed arthrocentesis of the left temporomandibular joint (TMJ), again without improvement. She was observed by dentistry, made 6 dental extractions without improvement.
 
 
 
 
 
 
 
 
 
 
 
 

MAIN COMPLAINTS

 
> Throbbing pain all day in the left temporomandibular joint (TMJ) area
> Could not eat or chew
> When opening her mouth slightly, it worsens
> RIGHT TMJ pain (7/10 on visual-analogue scale (VAS))
> LEFT TMJ pain (10/10)
> Refers to bilateral clicking, more accentuated on the left
 

SUMMARY OF THE OBJECTIVE EXAMINATION

 
 
> Limited maximum mouth opening (21mm)
> Severe pain on palpation of the TMJs
> Bilateral clicking
> Grade 3 muscle contracture
 
 
 
 
 
 

DIAGNOSIS

 
RIGHT TMJ:
> ANTERIOR DISC DISPLACEMENT WITH NO REDUCTION, TMJ OSTEOARTHROSIS
LEFT TMJ:
> ANTERIOR DISC DISPLACEMENT WITH NO REDUCTION, TMJ OSTEOARTHROSIS
> GRADE 3 MUSCLE CONTRACTURE

 

TREATMENT

 
> BILATERAL OPEN DISC REPOSITIONING SURGERY
> BOTOX PROTOCOL
> COGNITIVE COACHING
> STOMATOGNATHIC SYSTEM REHABILITATION
 
 
 
 
 
 
 
 

BEFORE AND AFTER

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

EVOLUTION OF PAIN IN THE LEFT AND RIGHT TEMPOROMANDIBULAR JOINT

 
 
 
 

EVOLUTION OF MOUTH OPENING

 
 
 
 

" I HAVE A NEW LIFE WITH MUCH MORE QUALITY OF LIFE. "

 
Adília Marques
 
 
 
Testemunho - Adília Marques
 
 
 
 
 

Equipa Responsável

 
 
Prof. Doutor David Ângelo
 
 
 
Dr. David Sanz
 
 
 
 
 
 

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