Loose intra-articular body in the temporomandibular joint: case report of a successful conservative management

Abstract

Loose intra-articular bodies are a rare finding in the temporomandibular joint. Surgical removal of the loose bodies is often described as the only treatment option; however, it presents possible postoperative complications. The aim of this paper is to report the successful conservative management of a temporomandibular disorder associated with a single loose intra-articular body. A 62-year-old woman presented with pain in the right temporomandibular joint and pre-auricular region, limited mouth opening and open-lock episodes. Panoramic radiography and cone-beam computed tomography exams revealed the presence of a single loose body located anterior to the right condyle. Magnetic resonance images showed bilateral anterior disc displacement without reduction. A non-invasive approach consisting of an occlusal splint and low-level laser therapy associated with home-based physical therapy was performed for management of clinical signs and symptoms. The patient was followed up for 2 years and presented significant pain reduction and improvement in the range of mandibular movements. The combination of conservative therapies may be an alternative for surgical intervention to control pain and improve mandibular function in patients with temporomandibular dysfunction associated with a loose body in the temporomandibular joint.