Use of Mini-anchors and Rehabilitation with 0° Cusp Angle Teeth Complete Denture in Recurrent Condylar Dislocation: Technical Adequacy and Procedure

Abstract

Aim:To report a case of association between the surgical treatment of temporomandibular dysfunction and rehabilitation with denture total prosthesis (TP) using nonanatomic teeth (cusp 0°) in patients with anterior recurrent dislocation of the temporomandibular joint (TMJ) and persistent uncontrolled mandibular movement, showing a technical adaptation and conduct.Introduction: There are several treatment approaches available for dislocation of the TMJ. The use of condylar mini-anchors for recurrent TMJ dislocation is a valid option and should be considered since it does not alter the joint anatomy. In edentulous patients undergoing TMJ surgical procedures, prosthetic rehabilitation can be seen as a means of treatment preservation. Case report:A 73-year-old female patient attended the oral and maxillofacial surgery clinic presenting with joint instability, ligament laxity, and chronic recurrent TMJ dislocations. She had already been through three previous unsuccessful surgical procedures. A treatment plan was done based on the installation of a mini-anchor in the patient's TMJ through the preauricular surgical access. Dislocations were then resolved, but the lack of mandibular control even to a lesser extent after surgery precluded the use of prosthetics even at rest. Conclusion:The use of an individual mini-anchor is simple and effective, and the use of artificial teeth is well suited to the case.Clinical significance: A multidisciplinary intervention (surgery/ prosthesis) is of utmost importance for the resolution and preservation of the treatment of these complex cases.

Prevalência de sintomas de Disfunção Temporomandibular em pacientes com necessidades reabilitadoras do HUB/Ebserh, no período de 2016 a 2021

“…Convencionalmente, pensava-se que a DTM era causada pela perda de suporte oclusal e aumento na carga da articulação, o que levaria à predisposição ao deslocamento do disco articular e doenças degenerativas da articulação (Carlsson, 2010;Dhanda, et al, 2011;Abdelnabi & Swelem, 2015;de S Leão et al, 2017). Entretanto, estudos atuais sugerem que a DTM pode causar todos esses transtornos e ser originada por múltiplos fatores, como traumatismos (macro ou microtraumas), doenças sistêmicas, fatores psicológicos, ansiedade, genética, entre outros, seguindo o modelo biopsicossocial (Abudet al, 2011;Badel et al, 2012;Papagianni, et al, 2013;Campos et al, 2014;Ribeiro et al, 2014;Katyayan et al, 2016;com Para o diagnóstico correto de DTM, é de suma importância a execução de boa anamnese, investigando-se o histórico e escala da dor do paciente, aplicação de questionário específico, como o DC/TMD (Schiffman et al, 2014); sendo fundamental executar um criterioso exame físico, por meio da palpação dos músculos mastigatórios, dos músculos cervicais, da ATM, orientar o paciente a realizar movimentos funcionais (de abertura, protusão, lateralidade), mensurar a abertura bucal máxima e, caso seja necessário, solicitar exames de imagem (ressonância magnética, tomografia computadorizada, artrografia) (Ferreira, et al, 2016).…”