Chronic Hemifacial Pain and Temporomandibular Joint Symptoms in a Patient With Posterior Occlusal Collapse Undergoing Implant Rehabilitation: A Case Report

Résumé fourni par la source

Posterior tooth loss may result in loss of occlusal support and alterations in masticatory function; however, the relationship between occlusal factors and temporomandibular disorders (TMDs) is complex, multifactorial, and remains controversial.This report describes the comprehensive rehabilitation of a 38year-old female patient (American Society of Anesthesiologists (ASA) Physical Status Classification I) who presented with chronic right-sided hemifacial pain, recurrent right-sided headaches, pain localized to the right temporomandibular joint (TMJ), and difficulty chewing.Clinical examination and cone-beam computed tomography (CBCT) demonstrated absence of the mandibular right first and second molars, with loss of posterior occlusal support, together with a mesioangularly impacted mandibular right third molar occupying the posterior edentulous region.Treatment consisted of surgical extraction of the impacted third molar followed by placement of two dental implants and subsequent implant-supported prosthetic rehabilitation of the missing posterior teeth.After a six-month osseointegration period, definitive implantsupported crowns were fabricated using a digital workflow and delivered with careful occlusal adjustment.At the three-month follow-up after prosthetic loading, the patient reported resolution of the chronic hemifacial pain, recurrent headaches, and TMJ discomfort, together with improvement in masticatory function.Clinical and radiographic examinations demonstrated stable peri-implant tissues and satisfactory functional rehabilitation.Because treatment involved sequential surgical and prosthetic interventions and standardized symptom assessments were not obtained after each treatment stage, the improvement cannot be attributed to any individual intervention, nor can a causal relationship between the patient's occlusal condition and presenting symptoms be established.This case documents a temporal association between comprehensive posterior dental rehabilitation and symptom improvement, and further studies are needed to clarify the relationship between posterior occlusal support and temporomandibular symptoms.

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