THE EFFECTS OF MANUAL THERAPY AND HOME EXERCISE IN A CANCER PATIENT WITH COMPLICATIONS AFTER THIRD MOLAR EXTRACTION: CASE REPORT

Purpose: Pain, oedema, and, more rarely, infection and trismus may occur after third molar extraction. The risk of these complications increases in patients with immunosuppressive conditions such as cancer, diabetes, and HIV (Human Immunodeficiency Virus). The aim of this case study was to report a patient with metastatic breast cancer who developed infection, persistent oedema and trismus following extraction of the third molar and the effect of manual therapy.

Methods: A 60-year-old patient with a history of type II diabetes with metastatic breast cancer developed left mandibular and deep neck infection, oedema, and trismus after surgical extraction of 3 molars in the 2nd week after the diagnosis of cancer. The patient presented with pain, hard oedema, and trismus on the 85th postoperative day, although the infection had disappeared and the oedema level had decreased. The patient underwent a 6-week manual therapy and home exercise programme to increase the limited mouth opening distance.

Results: After this treatment, significant improvements were noted in the level of pain, oedema, trismus, disability due to craniofacial pain, and mandibular dysfunction.

Discussion: In specific patient groups, manual therapy-based physiotherapy can be considered an effective approach for complications such as persistent oedema and trismus in the temporomandibular region after molar surgery.