Meeting abstract

Temporomadibular Disorders in a Patient With Anxiety

Tomislav Badel
Josip Pandurić
Sonja Kraljević
Miljenko Marotti
Lovko S. Kocijan
Jozo Šutalo

Abstract

A patient (28 yrs. old) during the last year has noticed wear facets on the teeth and also symptoms of temporomandibular disorders (TMD) - pain, limitation of mandibular movements, and also clicking in the right temporomandibular joint (TMJ). The pain was evaluated with analog-visual scale (0 - 10) = 7. Case history revealed the presence of mental trauma four years ago, which had caused the increase of anxiety and occurrence of panic attacks. By means of manual functional analysis myofacial pain and anterior disc displacement without reduction in the right TMJ was determined and confirmed with electronic axiography and magnetic resonance imaging (MRI). As a consequence of excessive teeth wear the interfering contacts in laterotrusive movements of mandibule were established. Anxiety was confirmed with psychological measuring instrument State-Trait Anxiety Inventory. For the initial treatment the fabrication of Michigan splint was indicated. After 2 months improvement in clinical condition was achieved. Stronger pain was only during larger mouth opening. In the right TMJ crepitation was found. In the last few months she took irregularly prescribed anxiolytic drugs. She still feels anxious, tense and insecure. After 9 months the anterior disc dislocation without reduction and with present signs of subchondral degeneration and condylar aplation in the right TMJ was established with controlling MRI. Orthopedic stability of TMJs was established with definitive occlusal treatment (restoration of wear teeth tissues with composite fillings). Because of accompanying osteoarthritis and better stabilisation of TMJs as well as teeth protection from bruxism a stabilisation splint was fabricated. Bruxism is a pathophysiological disorder of unclear aetiology. The most noticeable sign of bruxism is excessive teeth wear which can cause pathological occlusal relationships. The mechanism of aetiopathogenesis of TMD is insufficiently explained and occlusion is considered to be a secondary aetiological factor. Anxiety can be a pathophysiological factor of bruxism and can lead to persistence of chronic temporomandibular pain.

Keywords

Hrčak ID:

3053

URI

https://hrcak.srce.hr/3053

Publication date:

15.9.2003.

Article data in other languages: croatian

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