The mysterious case of persistent malocclusion

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Radiology

Background:

• Blunt trauma can cause complex maxillofacial injuries.
• Malocclusion is a significant indicator of dental and skeletal trauma.
• Temporomandibular joint (TMJ) injuries require thorough diagnostic evaluation.

Observation:

• A patient presented with persistent malocclusion after experiencing blunt facial trauma.
• Initial clinical examination and imaging ruled out obvious maxillary or mandibular fractures.
• Symptoms of malocclusion persisted for several days, necessitating further investigation.

Findings:

• Computed tomography (CT) revealed a foreign body lodged in the infratemporal fossa.
• A 4-cm pencil was identified as the foreign body.
• The pencil was located within the patient's right temporomandibular joint (TMJ).

Implications:

• Unusual foreign bodies can cause significant temporomandibular joint dysfunction and malocclusion.
• Advanced imaging like CT is crucial for diagnosing occult foreign bodies after trauma.
• Prompt surgical extraction of foreign bodies is essential for restoring function and preventing complications.