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Temporomandibular joint disk fracture: a case report
Marcello Melis1, Massimiliano Di Giosia, Simona Secci
1Craniomandibular Pain Center, Tufts University, Boston, Massachusetts, USA. marcellomelis01@libero.it
Cranio : the Journal of Craniomandibular Practice
|May 17, 2012
Summary
A fractured temporomandibular joint (TMJ) disc caused a posterior open-bite in a patient. The open-bite resolved spontaneously over four months, likely due to TMJ capsule remodeling and tooth extrusion.
Area of Science:
- Dentistry
- Orthodontics
- Radiology
Background:
- A rare case of temporomandibular joint (TMJ) disc fracture is presented.
- The patient exhibited posterior bilateral open-bite and masticatory difficulties due to absent posterior tooth contact.
Observation:
- Magnetic resonance imaging (MRI) confirmed a fractured right TMJ disc with posterior displacement of the posterior fragment and anterior displacement of the anterior fragment.
- Conservative TMJ manipulation was unsuccessful in repositioning the disc fragment.
- The patient declined TMJ arthroscopy for disc fragment removal.
Findings:
- The posterior open-bite showed significant reduction after four months.
- Spontaneous resolution is hypothesized to be linked to remodeling of the posterior TMJ capsule.
- Extrusion of posterior teeth (molars and premolars) may have contributed to bite closure.
Implications:
- This case highlights the potential for spontaneous, non-surgical resolution of TMJ disc fractures.
- TMJ disc displacement and associated malocclusion may exhibit adaptive remodeling.
- Further research is needed to understand the long-term outcomes and regenerative potential in TMJ disc injuries.
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