Two Cases of Fractured Mandibular Molars with Gingival Abscess in TMJ Patients

Abstract

  Two male patients aged 58 and 38 years mainly complained of pain in and around the unilateral ear. Upon completion of a TMJ examination in prosthetics or oral maxillofacial surgery, they were diagnosed as the TMJ arthrosis and then the dental routine treatment had been carried out there over a half year period. But the pain didn't disappear by their consultation and treatment. An Endodontist performed a pulpectomy of ⌈7 for this case 1, and soon the pain disappeared. In those two cases, a wide mesio-distal fracture through the tooth and abscess formation at the buccal gingiva were seen approximately 7 to 8 months later after the first visit.

  After the extraction of the teeth, the pain disappeared rapidly. They haven't relapsed for 18 months in the case 1 and 8 years and 2 months in case 2.

  Undecalcified ground sections cut in a bucco-lingual longitudinal direction of the extracted tooth in the case 1, revealed that the thin zone along the fracture line tended to appear radiolucently in CMR, and that there were mass granulomatous tissue around the fracture line at furcation site.

  In both cases, the teeth were noncarious and the crowns had severe attrition. The patients had well grown muscles of mastication and the habit of crunching hard foods with molars. It seemed that the excessive occlusal pressure for a long time caused a crack or fracture of tooth and that the following chronic pulpitis caused with referred pain.