Disc stability after condylar discopexy with open surgery technique. A case report.

Abstract

Of the temporomandibular joint (TMJ) pathologies, temporomandibular disorders (TMD) of disc displacement present several clinical signs and symptoms, the main ones being joint pain measured with the visual analogue scale (VAS) reporting on average VAS>6, and functional incapacity measured in mm of mouth opening, reporting on average <30mm in cases of TMD. The present case corresponds to a patient with limitation of mouth opening <15mm, joint pain VAS= 8, and functional limitation. The subject’s condition was diagnosed clinically and by magnetic resonance imaging (MRI). The patient presented a Wilkes VI lateral dislocation of the left condyle disc without reduction, treated with open surgery discopexy, with disc fixation by monocryl suture and retrodiscal thermocoagulation. The patient showed a significant improvement in the removal of pain and in joint function. In clinical checkups at 1 month, 3 months, 6 months and 1 year, the patient showed decrease of pain levels, from VAS= 8 to VAS= 0, and mouth opening of <15mm to 36mm in the last checkup. Clinical and imaging evaluation at 4 years shows disc stability, with maximum mouth opening of 36 mm, with no disc displacement and clinically asymptomatic VAS = 0. In this case, discopexy with open surgery achieved improvements in functional capacity and removal of pain at short term. Long-term stability was associated with anatomical functions without alteration and without relapse of the symptomatology.