After tooth extraction, she started complaining of pain in her right ear area. She started using brace without improvement. Refers to long-term clicks. The pains have intensified and have not improved with anything.
MAIN COMPLAINTS
> Right TMJ pain: 8/10 VAS
SUMMARY OF THE OBJECTIVE EXAMINATION
> Maximum mouth opening 38 mm > Right TMJ: G3 Synovitis (pain on mouth opening) with suspected disc displacement with reduction with osteoarthritis > Left TMJ: No changes > Grade 2 muscle contracture
DIAGNOSIS
RIGHT TMJ: > PREVIOUS DISC DISPLACEMENT WITHOUT REDUCTION WITH OSTEOARTHRITIS WITH SUBCHONDRAL CYSTS AND FLATTENING OF THE CONDYLE LEFT TMJ: > WITHOUT CHANGES > GRADE 2 MUSCLE CONTRACTURE
TREATMENT
> OPEN RIGHT TMJ SURGERY - FUNCTIONAL CONDYLECTOMY WITH JOINT REPLACEMENT > LYSIS AND WASHOUT ARTHROCENTESIS WITH LEFT TMJ VISCOSUPPLEMENTATION > BOTOX PROTOCOL > STOMATOGNATHIC SYSTEM REHABILITATION
BEFORE AND AFTER
EVOLUTION OF PAIN IN THE LEFT AND RIGHT TEMPOROMANDIBULAR JOINT