[A case of complete rupture of the righ TMJ disc]

A case of complete rupture of the right TMJ disc was described. A 43 year old woman visited our hospital with the chief complaint of a mild pain in the right TMJ. Initially, a conservative treatment using the occlusal splint (condylar repositioning appliance) was carried out. This was because she had reciprocal clicking of the right TMJ which had occurred not long before and it seemed that the symptoms were due to the trouble with the disc. In spite of this treatment, for 6 months no improvement was obtained and the reciprocal clicking changed into crepitation. Moreover the double contrast arthrotomographic image indicated a perforation or a wide rupture of the disc, and deformities of the articular bone. Then a right TMJ osteoarthrosis with wide (complete) disc rupture was diagnosed, and a discectomy was performed. The symptoms were greatly reduced by this treatment. It was conceivable that the steroid which she had used for a long time to treat bronchial asthma caused a remarkable inhibition of the tissue repairing, and an internal derangement of the TMJ rapidly progressed to osteoarthrosis.