Chronic dental infections mimicking temporomandibular disorders.
BACKGROUND
Trismus and jaw pain are not only caused by temporomandibular disorders (TMD), but also by various pathologies, namely infection, trauma, or neoplasms. TMD-like symptoms, as a result of the pathologies, may be confusing to a clinician. This paper reports two cases of chronic dental infection mimicking TMD.


METHODS
Two patients were initially diagnosed with, and treated for, TMD. However the patients did not respond to the treatment. Limited range of motion and jaw pain were then clinically evaluated for differential diagnoses. Laboratory examinations and computerized tomography (CT) scans were carried out to disclose any underlying lesion.


RESULTS
Laboratory examination, such as, C-reactive protein helped to detect latent infection. CT scans revealed insidious chronic dental infection imitating TMD. Surgical drainage and chemotherapy resolved the symptoms.


CONCLUSIONS
The importance of a rational diagnostic process, including clinical and laboratory examinations and radiologic imaging, cannot be over-emphasized in elucidating true cause of the symptoms.
Ogi
N
N
Second Department of Oral and Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Nagoya, Japan. ogi@dpc.aichi-gakuin.ac.jp
Nagao
T
T
Toyama
M
M
Ariji
E
E
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008406:Masseter Muscle / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D008964:Molar, Third / Q000473:pathology; D010482:Periapical Abscess / Q000150:complications / Q000175:diagnosis*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D014313:Trismus / Q000209:etiology
D002097:C-Reactive Protein