Diagnosis and Individualized Management of TMJ Synovitis with Secondary Symptoms: A Case Report

48th Annual Conference of the European Prosthodontic Association (EPA), Nevşehir, Türkiye, 11 - 13 Eylül 2025, cilt.1, ss.130, (Özet Bildiri)

INTRODUCTION: Temporomandibular disorders (TMD)

affect about one-third of the adult population and represent

a broad group of musculoskeletal conditions involving the

temporomandibular joint (TMJ) and associated structures.

Inflammatory joint disorders arise when the TMJ and adjacent

tissues become inflamed due to trauma, functional disturbances,

or systemic diseases. Synovitis, characterized by inflammation

of the synovial membrane, typically causes significant pain,

swelling, and restricted jaw movements. This case report

discusses the diagnosis and management of two distinct

patients presenting with synovitis, accompanied by chronic disc

displacement without reduction and secondary myalgic pain.

Case description: This case report presents two female

patients with persistent, severe unilateral TMJ pain and restricted

jaw function lasting more than one month. Diagnosis was made

through diagnostic criteria temporomandibular disorders (DC/

TMD) questionnaire and magnetic resonance imaging (MRI)

findings, confirming synovitis with chronic disc displacement

without reduction and myalgic pain. Both patients underwent a

three-month treatment protocol, combining pharmacological and

occlusal splint therapy. After three months, clinical reassessment

and questionnaire evaluations were performed. While one patient

showed significant improvement, the other had limited relief and

restricted functional movements necessitating arthrocentesis.

Splint therapy continued after the procedure. At the six-month

follow-up, clinical and radiological outcomes were re-evaluated.

DISCUSSION: MRIs and the DC/TMD form are crucial for

the accurate diagnosis of arthrogenic TMDs. The presence

of secondary conditions like myalgic pain complicates the

management and emphasizes the need for continuous follow-

up with different treatment combinations. Conservative therapy

should be the first-line treatment. When insufficient, minimally

invasive interventions like arthrocentesis should be considered.

Even among patients with similar clinical findings, individualized

treatment plans are essential. In this case series, the patient

who showed limited response to conservative therapy benefited

from arthrocentesis. The combination of pharmacological

treatment, arthrocentesis and continued occlusal splint therapy

enhanced treatment effectiveness, reduced symptoms, and

improved patient satisfaction over time.