Anterior Temporomandibular Joint Dislocation Research Articles

Orthodontic Mini-implants for Treatment of Long-term Anterior Dislocation of Temporomandibular Joint:

Acute dislocation of the temporomandibular joint (TMJ) is a relatively common occurrence; chronic long-term dislocation is rare. Variance in the duration of dislocation and anatomical considerations make the treatment for long-standing dislocation complex and controversial. This case report describes a new method of conservative management of a long-standing TMJ dislocation using orthodontic mini-implants.

The study of combined unilateral intraoral and extraoral reduction approach in the treatment of anterior temporo-mandibular joint dislocation

To observe the clinical outcomes of a combined unilateral intraoral and extraoral reduction approach in the treatment of anterior temporomandibular joint (TMJ) dislocation. Postural muscular chains were utilized in the biomechanical analysis of stomatognathic systems for improving TMJ repositioning approaches. A total of 87 patients with anterior TMJ dislocation were included in the present study. A combined unilateral intraoral and extraoral reduction approach was applied, and the clinical effects were evaluated. Biomechanical analysis reveal that reflexive contrac-tion of the maxillary muscle group was blocked sufficiently during the combined unilateral intraoral and extraoral reduction process. All dislocated TMJs were set successfully and efficiently with few complications. Combined unilateral intraoral and extraoral reduction approach is an effective, convenient, and minimally invasive way to treat anterior TMJ dislo-cations.

Management of the Most Common Type of Anterior Temporomandibular Joint Dislocation: A Systematic Review

Management of the Most Common Type of Anterior Temporomandibular Joint Dislocation: A Systematic Review

Temporomandibular joint dislocation in an epileptic and mentally retarded patient: a case report.

Temporomandibular joint (TMJ) dislocation is defined as an excessive forward movement of the condyle beyond the articular eminence with complete separation of articular surfaces and fixation in that position.' Theories regarding the pathogenesis of TMJ dislocation propose laxity of TMJ ligaments or capsule, excessive activity of the lateral pterygoid muscle (LPM)and erosion of the eminence'. TMJ dislocation can occur in an anterior, posterior, lateral and superior direction'. Clinical presentation of dislocated TMJ includes inability to close the mouth, deviation of the mandible away from the affected side in unilateral cases, hollowing in front of the tragus, spasm of muscles of mastication and severe pain of the TMt Radiographs show an empty condylar fossa with the condylar head located anterior to the articular eminence. Anterior TMJ dislocation usually follows excessive mouth opening during yawning, laughing, eclamptic fit and motor vehicle accident (MVA)'. Iatrogenic causes of TMJ dislocation are excessive mouth opening during dental treatment, intubation, and otorhinolaryngological procedures Some drugs are associated with TMJ dislocation, these include antiemetics such as metoclopramide and compazine which produce extrapyramidal effects' and neuroleptic drugs. Systemic connective diseases like Ehlers-Danlos and Marfan syndromes have also been implicated in TMJ dislocations The purpose of this article is to report management challenges of an epileptic and mentally retarded patient with recurrent TMJ dislocation.

Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial

This randomized clinical trial was designed to compare three different reduction methods for anterior temporomandibular joint (TMJ) dislocation. The three methods evaluated were the conventional method, wrist pivot method, and extraoral method. The study sample comprised 90 consecutive patients suffering from anterior dislocation of the TMJ, who were allocated randomly to one of the three groups. This study found success rates of 86.7% for the conventional method, 96.7% for the wrist pivot method, and 66.7% for the extraoral method. The extraoral method was more difficult for the physician and the patient than the other two methods. For the patients, the wrist pivot method was easier than the other methods. For the doctors, the extraoral method was significantly more difficult than the other methods. In conclusion, due to the absence of a biting risk with the extraoral method and the lack of a significant difference in success between this method and the conventional method, the extraoral method could be considered the appropriate first-line treatment where there is a risk of the patient biting the surgeon's hand. Given the overall benefits of the wrist pivot method, this method could be considered the first-line and gold standard treatment modality in other cases.

Dislocation of bilateral temporomandibular joint in a critically ill patient after seizure

Spontaneous anterior temporomandibular joint dislocation is a rare scenario. Underlying systemic diseases such as epilepsy may predispose a patient to temporomandibular joint dislocation. We present here such a case of bilateral anterior temporomandibular joint dislocation following a single episode of seizure in a critically ill patient, which required to be diagnosed and treated urgently.

A Missed Case of Occult Bilateral Temporomandibular Dislocation Mistaken for Dystonia.

A 24-year-old male with a history of psychiatric disorder and no prior significant temporomandibular joint (TMJ) pathology presented to the emergency department for “lockjaw.” Plain film X-rays of the mandible were read as unremarkable by an attending radiologist, leading to the initial diagnosis of medication-induced dystonic reaction. Following unsuccessful medical treatment a maxillofacial computed tomography (CT) was ordered. CT confirmed bilateral dislocation, illustrating the importance of clinical judgment, and limitations of certain radiographic images. The authors believe this case to be the first reported case in the medical literature of bilateral anterior TMJ dislocation with a false negative X-ray.

Orthodontic Mini-implants for Treatment of Long-term Anterior Dislocation of Temporomandibular Joint

Orthodontic Mini-implants for Treatment of Long-term Anterior Dislocation of Temporomandibular Joint

Traitement de la luxation temporo-mandibulaire récidivante par abaissement de l’arcade zygomatique : modification de la technique de Gosserez et Dautrey

Many methods have been reported for the surgical treatment of recurrent anterior temporomandibular dislocation. Most of these techniques are designed to limit the forward migration of the condylar head. The great number of surgical techniques experimented illustrates the difficulty to find a satisfactory method for the treatment of these recurrent dislocations. We present a modification of Gosserez and Dautrey's surgical technique for the treatment of recurrent anterior temporomandibular joint dislocation. The surgical technique is described and its indications are discussed.

Unrecognized bilateral temporomandibular joint dislocation after general anesthesia with a delay in diagnosis and management: a case report

IntroductionAnterior bilateral temporomandibular joint dislocation is not an uncommon occurrence and has been reported before. However, its diagnosis can easily be overlooked, especially by clinicians who are unfamiliar with this pathology. Continuous discussion of the pathology is required to prevent delays in diagnosis, which can lead to long-term sequelae for the patient.Case presentationWe present the case of a 66-year-old Somali woman who experienced a bilateral anterior temporomandibular joint dislocation after a general anesthetic for an exploratory laparotomy for excision of a pelvic sarcoma. She first presented in the intensive care unit with preauricular pain and an inability to close her mouth, and was initially misdiagnosed and treated for a muscle spasm. The cause of her misdiagnosis was multifactorial - opioid-related sedation, language and cultural barrier, and unfamiliarity with the pathology. Her diagnosis was proven 18 hours after the completion of surgery with a plain X-ray. A manual closed reduction was performed with minimal sedation by oral surgery.ConclusionWe provided an in-depth discussion of temporomandibular joint dislocation and suggest a simple test that would prevent delayed diagnosis of temporomandibular joint dislocation in any patient undergoing general anesthesia. A normal mandibular excursion should be tested in every patient after surgery in the postoperative care unit, by asking the patient to open and close their mouth during the immediate postoperative recovery period or passively performing the range of motion test.

Bilateral Temporomandibular Joint Dislocation With Locked Mandibular Impaction

Bilateral anterior temporomandibular joint dislocation is very rare, with only 2 reported cases published. In the present report, we describe a healthy 25-year-old man from Haida Gwaii, in British Columbia, Canada, who was transferred to our tertiary trauma center with life-threatening complications of a bilateral anterior temporomandibular joint dislocation with locked mandibular impaction.

Anterior bilateral temporomandibular joint dislocation: an emergency presentation

Anterior dislocation of the temporomandibular joint (TMJ) though an infrequent presentation at the emergency department; often demands an immediate reduction to relieve discomfort and prevent adverse long-term sequelae. A simple and effective technique to reduce the dislocation is successfully demonstrated by putting the operator's thumbs over the molar teeth of the patient and pushing the dislocated jaw downward and backward. We report the case of a patient who presented at our accident and emergency department with bilateral anterior TMJ dislocation and was successfully reduced with this simple technique.Keywords: Temporomandibular joints (TMJ), dislocation

Temporomandibular joint dislocation in Nairobi

Despite the diverse conservative and surgical modalities for the management of temporomandibular joint (TMJ) dislocation and the controversy that surrounds them, very little has been done within the East-African setup in terms of highlighting and provoking greater interest in the epidemiology and management of TMJ dislocation. To audit the pattern of occurrence, demographics, aetiology and enumerate the treatment modalities of TMJ dislocation at the oral and maxillofacial surgery division (OMFS) of the University of Nairobi Dental Hospital. Descriptive cross-sectional study. University of Nairobi Dental Hospital (UNDH) from January 1995 to July 2005. Twenty nine patients had been diagnosed and managed for TMJ dislocation. Twenty (69%) were females and nine (31%) were males. Their ages ranged from 10-95 years with a mean of 42 years. The cases managed were primarily chronic in nature. The most common form being anterior TMJ dislocation, accounting for twenty-five (86.2%) cases. Trauma was implicated as an aetiology in only five (17%) of the cases while the remaining majority of twenty four (83%) cases were spontaneous. Amongst the causes of spontaneous TMJ dislocation, yawning was the most common accounting for fourteen cases (48.3%). Dislocations caused by trauma were found to be 12.6 times more likely to be associated with other injuries than spontaneous dislocations. Anterior TMJ dislocations were found to be 1.3 times more likely to be associated with absence of molars than posterior TMJ dislocations. Anatomical aberrations, as predisposing factors, were not a significant finding in this research. Eight (28%) of the cases were managed conservatively. Twenty one (72%) of the cases were managed surgically. The eminectomy was the most common technique with a 75% success rate. The highest incidence of TMJ dislocation occurs in the 3rd-5th decade with a female preponderance with bilateral anterior TMJ dislocation being the most common. Most of the cases were managed surgically with eminectomy being the preferred technique with the highest success rate. A study needs to be undertaken to determine reasons' why conservative modalities are least employed in the management of TMJ dislocation in our setup and what can be done about it.

Bilateral temporomandibular joint dislocation in a 29-year-old man: a case report

IntroductionA dislocation of the temporomandibular joint represents three percent of all reported dislocated joints.The treatment entails reduction of the deformity and this can often be achieved in a ward setting.Case presentationWe present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient analgesia and sedation, joint reduction had to be performed in theatre with the patient under general anesthesia.ConclusionThis case highlights the importance of providing the patient with adequate analgesia and sedation when attempting the reduction of temporomandibular joint dislocations.

An unusual case of bilateral anterior shoulder and mandible dislocations

Unilateral anterior shoulder dislocation is the most common major joint dislocation seen by emergency physicians. Bilateral glenohumeral dislocations are rarely seen and almost always posterior after seizure or electrical shock. We present an unusual case of bilateral anterior dislocation of shoulder that had anterior dislocation of temporomandibular joint simultaneously. These problems occurred after a course of generalized tonic-clonic seizure. The coincidence of these dislocations is the first case published in the literature.

Temporomandibular joint dislocation after use of a laryngeal mask airway

Use of the laryngeal mask airway has not previously been reported to be associated with bilateral temporomandibular joint (TMJ) dislocation. A size 4 laryngeal mask airway was inserted, without difficulty, in a 45-year-old female undergoing breast surgery. As she regained consciousness in the postoperative recovery room, it was noticed that she was unable to close her mouth, complained of bilateral sore temporomandibular regions and her speech was mumbled. Her jaw was not deviated. Anterior bilateral TMJ dislocation was diagnosed clinically. There was no history of previous TMJ dislocation. Successful reduction was done with manipulation directed inferiorly and posteriorly using propofol for sedation. A relocation ‘clunk’ was felt bilaterally and heard. On awakening, the patient was able to close her mouth, move her jaw without difficulty and talk normally. Relocation was confirmed with an orthopantomogram. Use of a laryngeal mask airway predisposes to pharyngolaryngeal trauma [1], sore throat and dysphagia [2], but has not previously been reported to be associated with bilateral TMJ dislocation. There are, however, several reports of bilateral TMJ dislocation associated with anaesthesia [3, 4]. TMJ dislocation occurred with wide opening of the jaw to place an oropharyngeal airway and nasogastric tube in a mechanically ventilated patient undergoing exploratory laparotomy [3]. This incident was preceded by uneventful laryngoscopy for tracheal intubation. TMJ dislocation was reported after thiopental induction but prior to laryngoscopy for tracheal intubation [4]. Wide mouth opening predisposes to bilateral anterior TMJ dislocation, occurring when the condylar heads are forced to a position anterior to the articular eminence away from their resting position within the glenoid fossa. The patient is then unable to close their mouth (the jaw is held in a lowered but central position), has difficulty speaking and experiences pain in the TMJ region bilaterally [5]. A jaw thrust to lift the pharyngeal structures anteriorly facilitates the passage of a laryngeal mask airway into the hypopharynx with less epiglottic contact [6]. Loss of motor response to jaw thrust (to assess depth of anaesthesia for laryngeal mask airway inertion) [7] may predispose to TMJ dislocation, by anteriorly displacing the mandible [8].

A case of old anterior temporomandibular joint dislocation treated by lysis and lavage using arthroscopic technique and manual reduction

A case of old anterior temporomandibular joint dislocation treated by lysis and lavage using arthroscopic technique and manual reduction