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Medicina
Croatian Medical Association - Rijeka branch
ISSN: 0025-7729
Vol. 44, No. 1, 2008, pp. 80-84
Bioline Code: me08013
Full paper language: Croatian
Document type: Case Report
Document available free of charge

Medicina, Vol. 44, No. 1, 2008, pp. 80-84

 en Temporomandibular joint disorder in a 12-year-old female patient
Badel, Tomislav; Lajnert, Vlatka; Marotti, Miljenko; Krolo, Ivan & Pavičić, Daniela Kovačević

Abstract

Introduction: Functional disorders of the stomatognathic system are included among temporomandibular disorders (TMDs). There are many etiological factors which can be of different importance for certain patients. Temporomandibular joint (TMJ) disorders include the anterior disc displacement (DD) and/or articular osteoarthritis. The prevalence of displaced TMJ disc in childhood and adolescence is low. The most frequent symptoms are clinically slightly expressed.
Case report: Here, we describe the case of a 12-year-old girl with TMD. The patient reported clinical signs and symptoms (clicking) in TMJs bilaterally and has been referred by the orthodontist because she needed treatment of the cross-bite. The magnetic resonance imaging of the left TMJ showed DD without reduction and DD with reduction in the right TMJ. Painless clicking in the TMJ is an insufficient clinical finding which would require treatment of TMD.
Conslusions: Clicking is the result of articular disc repositioning on mouth opening and its return into the displaced position on mouth closing. So far, there has been only a description of a large number of risk factors and no evidence of the correlation between causal factors. Therefore, for patients’ benefit, it is necessary to determine appropriate diagnostic and therapeutic procedures in order to improve the function of the masticatory system. The cross-bite was not an occlusal anomaly associated with TMD, but the orthodontic treatment as a form of definitive rehabilitation of occlusion has to be carried out very carefully.

Keywords
disc displacement, magnetic resonance imaging, temporomandibular disorders, temporomandibular joint

 
 hr Poremećaj čeljusnog zgloba u 12-godišnje bolesnice
Badel, Tomislav; Lajnert, Vlatka; Marotti, Miljenko; Krolo, Ivan & Pavičić, Daniela Kovačević


Uvod: Funkcijski poremećaji stomatognatog sustava obuhvaćeni su pod pojmom temporomandibularni poremećaji. Njihova etiologija je multifaktorijalna, a mogući etiološki čimbenici mogu imati različitu važnost u pojedinih bolesnika. Poremećaji čeljusnog zgloba su anteriorni pomak zglobne pločice i osteoartritis. Prevalencija pomaka zglobne pločice u djece i adolescenata je niska, a klinički simptomi su najčešće blago izraženi.
Prikaz slučaja: U ovom radu opisan je klinički slučaj 12-godišnje bolesnice s temporomandibularnim poremećajem, koja je imala kliničke znakove i simptome škljocanja u oba čeljusna zgloba. Uputio ju je ortodont jer je trebala terapiju križnog zagriza. Magnetskom rezonancijom utvrđen je anterioni pomak zglobne pločice bez repozicije u lijevom i s repozicijom zglobne pločice u desnom čeljusnom zglobu.
Zaključak: Bezbolno škljocanje nije dostatan simptom koji bi indicirao liječenje tempromandibularnog poremećaja. Škljocanje je posljedica repozicioniranja zglobne pločice tijekom otvaranja usta i ponovnog vraćanja u anteriono pomaknut položaj tijekom zatvaranja usta. Sve dok ne postoji dokazana povezanost s kauzalnim čimbenicima, nego samo opis brojnih čimbenika rizika, za bolesnika je važno utvrditi odgovarajuću mjeru dijagnostičkih i terapijskih postupaka kojima se može poboljšati funkcija žvačnog sustava. Iako se križni zagriz ne smatra okluzijskom anomalijom povezanom s temporomandibularnim poremećajima, treba provesti vrlo pažljivo ortodontsko liječenje kao oblik definitivne rehabilitacije.


čeljusni zglob, magnetska rezonancija, pomak zglobne pločice, temporomandibularni poremećaji

 
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