title: Clinical-surgical treatment of temporomandibular joint disorder in a psoriatic arthritis patient.
abstract: BACKGROUND
  Condylotomy is a surgical procedure that has been used as an option to treat temporomandibular disorder (TMD) patients. This technique has the advantage of avoiding intra-capsular alterations that might be found involving other surgical procedures. Its use, even when unilateral, has positive effect on treatment of both joints.
  
  
  METHODS
  In order to better evaluate the benefits of a clinical-surgical treatment for TMD, the present report describes the case of a psoriatic arthritis patient. The case was clinically characterized by dental malloclusion, and imaging exams showed joint degeneration of the right mandibular condyle. The patient was treated by condylotomy technique after a prosthetic oral rehabilitation.
  
  
  RESULTS
  No clinical-radiological signs or symptoms of progression of articular disease were observed within a period of 16 months after surgery. Furthermore, there was functional stability of the temporomandibular joint, total absence of local pain and improvement of mouth opening.
  
  
  CONCLUSIONS
  The present study suggests that condylotomy can be considered as a valid option for the management of TMD, since it has low surgical morbidity and favorable clinical outcomes. In this case, the patient had a medical diagnosis of systemic disease presenting general pain and pain at the temporomandibular joint (TMJ), in addition of causal agent of TMD (dental malloclusion). The difficulty of finding a single etiology (malocclusion vs. systemic disease) did not exclude the indication of a clinical-surgical treatment to re-establish the balance of TMJ.
authors.affiliation: Irmandade Santa Casa de Misericórdia de Porto Alegre, ISCMPA, Porto Alegre, RS, Brazil. epuricelli@uol.com.br
authors.forename: Edela
authors.initials: E
authors.lastname: Puricelli
authors.forename: Adriana
authors.initials: A
authors.lastname: Corsetti
authors.forename: Julieta Gomes
authors.initials: JG
authors.lastname: Tavares
authors.forename: Giuliano Henrique Mião
authors.initials: GH
authors.lastname: Luchi
mesh_terms: D000368:Aged; D015535:Arthritis, Psoriatic / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008310:Malocclusion / Q000150:complications; D008334:Mandible / Q000601:surgery; D010027:Osteotomy; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D014057:Tomography, X-Ray Computed
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