Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation.

Abstract

Mandibular dislocation occurs when the condylar head glides out of the glenoid fossa with the condyle positioned in such a way that its posterior articulating surface lying ahead of the articular eminence. Recurrent mandibular dislocation is relatively uncommon. Patient is extremely distressed and goes through a lot of discomfort. Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs. Acute dislocations are best managed immediately by reduction and intermaxillary fixation. However, dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible. Such chronic recurrent dislocations are surgically managed with eminectomy, meniscectomy, and condylotomies. A downward and forward osteotomy of the zygomatic arch in front of the articular eminence so as to produce a mechanical obstruction was recommended by Dautrey and Gosserez. This article will highlight the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints (TMJs) bilaterally employing Dautrey's procedure.