If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Corresponding author: Prof. Salvatore Sembronio MD, PHD, FEBOMFS, Associate Professor of Maxillofacial Surgery Department, University Hospital of Udine, Maxillofacial Surgery Unit, Academic Hospital of Udine, Department of Medicine, University of Udine, Piazzale S. Maria della Misericordia 1, 33100 Udine
A 49-year-old woman was referred to the Maxillofacial Surgery Department of our University
to evaluate a worsening jaw pain lasting since three-years. She experienced increasing
preauricular pain in the area of the left temporomandibular joint (TMJ), during the
day and night, and a progressive limitation of mouth opening over the past few years.
The patient denied bruxism or jaw clenching. She had been treated by various health
professionals, including physiotherapists, osteopaths and orthodontists over the years.
She also used with 4 different splints, with little or no symptomatologic relief.
Non-steroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants were taken chronically
by the patient with little or no result. The patient did not report any previous trauma,
infections, arthritis or other rheumatological disease. At physical examination she
showed a maximum mouth opening (MMO) of 29 mm with the chin deviating slightly to
the left side (Fig. 1 A-1B). She was painful on palpation of the preauricular and temporal area bilaterally.
Furthermore, the masticatory muscles resulted bilaterally painful. Mild swelling in
the left TMJ area was observed. An articular crepitus of the left TMJ was perceived.
Forcing the MMO, the endfeel was rigid and painful. The computed tomography (CT) (Fig. 2 A-B) and the magnetic resonance imaging (MRI) (Fig. 3 A-B) scans showed an osteoarthritic degeneration of the left TMJ.
Fig. 1A-B: Clinical appearance of the patient at first clinical evaluation; a reduction
of the mouth opening and a slight deviation to the left are visible.
Fig. 2A-B: Coronal and sagittal CT scans shows a moderate osteoarthritis of the left TMJ;
it is also possible to notice the sclerotic appearance of the of the left TMJ bones
in contrast with the right side.
Fig. 3A-B: Sagittal T2w open mouth scan showing the articular disk damaged and anteriorly
displaced with no reduction. Coronal T1w MRI scans showing on the left TMJ signal
alteration as from arthritic-sclerotic thickening of the mandibular condyle and flattening
of the articular surface.
