PROSTHODONTIC TREATMENT OF A PATIENT WITH RHEUMATOID ARTHRITIS WITH SEVERE CONDYLAR RESORPTION: 4-YEAR FOLLOW-UP-Aşırı Kondiler Rezorpsiyonu Olan Romatoid Artritli Bir Hastanın Protetik Tedavisi: 4 Yıllık Takip

Ali BALIK, Özlem OCAK-ÇİMENDUR, Meltem ÖZDEMİR-KARATAŞ, Mahmut ÖMER, Bilge GÖKÇEN-RÖHLİG
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Abstract


ABSTRACT
In this study, dental management and 4 years follow up of a 45 years old patient with a 6 years medical history of rheumatoid arthritis with limited mouth opening and masticatory muscles tenderness was evaluated. The clinical examination revealed an anterior open bite thought to be a result of
condylar resorption due to TMJ involved rheumatoid arthritis. In this case prosthodontic management was planned to be the treatment choice rather than advanced TMJ surgical rehabilitation. Prosthodontic management was decided according to clinical, radiographic examinations and patient’s demands were
considered. The prosthodontic management optimized the inter-occlusal relationship to maintain both functional and esthetic integrity. As a result the traumatic effect to the TMJ was reduced and 4 years follow up reveals that condylar resorption remained stable and no open bite occurred.

Keywords: TMJ, rheumatoid arthritis, condylar resorption

ÖZ
Bu yazıda 6 yıllık romatoid artrit tedavisi sonrası ağız açıklığında kısıtlılık, çiğneme kaslarında ağrı, yemek yeme ve çiğneme problemleri ile kliniğimize gelen 45 yaşındaki bir hastanın dental tedavileri ve 4 yıllık takibi sunulmuştur. Klinik muayenede, romatoid artritin TME tutulumu nedeniyle oluşan kondiler rezorpsiyona bağlı ön açık kapanış gözlenmiştir. Bu vakada ileri TME cerrahisi yerine alternative olarak protetik tedavi planlandı. Yapılan klinik, radyolojik incelemeler ile hastanın istek ve beklentileri değerlendirilerek protetik tedavi planlanmıştır. Protetik tedavi ile uygun çeneler arası
kapanış sağlanarak hastanın çiğneme fonksiyonu ve estetik görünümü düzeltilmiştir. Sonuç olarak TME’e gelen travmatik etki azaltılmış ve hastanın 4 yıllık takibinde ön açık kapanışın tekrar oluşmadığı ve kondiler rezorpsiyonun durduğu gözlenmiştir.

Anahtar kelimeler: TME, romatoid artrit, kondiler rezorpsiyon


Keywords


TMJ, rheumatoid arthritis, condylar resorption

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DOI: http://dx.doi.org/10.17096/jiufd.81837

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Corresponding Author : Ali BALIK Department of Maxillofacial Prosthodontics Faculty of Dentistry Istanbul University 34093, Capa, Istanbul / Turkey. Phone: +90 212 414 20 20 - 30262 e– mail: dralibalik@gmail.com




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