Sembronio Salvatore, Albiero Alberto Maria, Robiony Massimo, Costa Fabio, Toro Corrado, Politi Massimo
Department of Maxillofacial Surgery, Faculty of Medicine, University of Udine, Udine, Italy.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Feb;103(2):e1-6. doi: 10.1016/j.tripleo.2006.08.028. Epub 2006 Nov 7.
Septic arthritis of the temporomandibular joint (TMJ) is infrequently reported. We present a case of septic arthritis of the TMJ following the extraction of the left upper second molar that occurred 1 week before beginning of symptoms. No evident predisposing factors were detected. Arthroscopic diagnosis of septic arthritis, lysis and lavage, and capsular stretch were performed. Cultures taken from the TMJ space grew Streptococcus sp. After 1 month of antimicrobial therapy the patient was asymptomatic and mandibular function was normal. Literature related to septic arthritis of TMJ and its treatment was reviewed. Different surgical procedures are available to treat this condition. Arthroscopy should be preferred as initial treatment on account of the possibility of drainage and accurate lavage under direct visualization of joint space, at the same time allowing confirmation of diagnostic hypotheses. Improving joint mobility with lysis of adhesions and capsular stretch in an early stage of disease may be helpful in stopping the fibrosis process.
颞下颌关节（TMJ）的化脓性关节炎报道较少。我们报告一例TMJ化脓性关节炎病例，该病例发生在左上第二磨牙拔除后1周，症状开始前。未检测到明显的诱发因素。进行了化脓性关节炎的关节镜诊断、松解和灌洗以及关节囊扩张。从TMJ间隙采集的培养物培养出链球菌属。经过1个月的抗菌治疗，患者无症状，下颌功能正常。回顾了与TMJ化脓性关节炎及其治疗相关的文献。有不同的外科手术方法可用于治疗这种疾病。关节镜检查应作为初始治疗方法，因为它有可能在直视关节间隙的情况下进行引流和精确灌洗，同时还能确认诊断假设。在疾病早期通过粘连松解和关节囊扩张改善关节活动度可能有助于阻止纤维化进程。
