A Young Patient with TMJ Osteoarthritis: Case Report
The 21-year-old patient was referred because of pain in front and in the right TMJ, which increased during mandibular movements. Medical history revealed that 3 months ago, the patient was involved in a traffic accident where she suffered a strong blow to the head. Since then difficulties while opening and pain during the normal functional movements and mastication were present.

Clinical diagnostics Palpation of the masticatory muscles did not provoke pain, but palpation of the lateral pole and provocation tests (opening and protrusive movements) produce report of “familiar pain”. Crepitus of the right TMJ was detected with palpation. During clinical examination limitation in mouth opening was found, with unassisted opening of 22 mm. The application of mild force in the direction of the mouth opening failed to increase the opening of more than 2 mm.

During mouth opening, uncorrected deviation to the right side was present. Patient reported pain in the right TMJ during left lateral excursion. Left lateral movement. was 8 mm, while the right lateral movement was 11 mm, and was carried out without pain. The amount of protrusion was 6 mm. Opening and protrusion provoked a report of “familiar pain.”
Patient self-assessed the level of pain using visual-analog scale (VAS = 0-10) as VAS = 7. During lateral movements crepitus in the right TMJ was detected.

Dental status Clinical examination and analysis of panoramic radiograph revealed that the patient’s teeth were treated previously and were without prosthodontic restorations. In the transversal plane there was a 3 mm displacement of the medial line. Interdental spacing was present. The teeth 18, 28, 48 were erupting, while the tooth 38 was missing. Vertical overbite and horizontal overjet amounted to 4 mm.

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