Temporomandibular Joint Dislocation Research Articles

Autologous blood injection for treatment of chronic recurrent TMJ dislocation: is it successful? Is it safe enough? A systematic review.

The purpose of this article is to review the English literature about the efficacy and safety of autologous blood injection in treating patients suffering from chronic recurrent temporomandibular joint dislocation. In this article, we highlight the key trials and recent directions about this modality and discuss about the mechanism, advantages, and disadvantages of this approach. A literature search was performed using PubMed, Medline, and Ovid Medline databases to identify articles reporting on the injection of autologous blood for treatment of chronic recurrent dislocation of temporomandibular joint. Other references cited in the retrieved reports, as well as the "related articles" tool in PubMed Medline, were also checked to improve the search and, if relevant, were included in the study. The search was restricted to articles published in the English language. Seven studies meeting the inclusion criteria were reviewed. The selected articles included four prospective clinical trials and three case report articles. There are a few articles about the clinical use of autologous blood for treating patients with chronic recurrent temporomandibular joint dislocation. Reviewing of the literature shows that there are successful results about this modality, but there are still some concerns about it in terms of the effect of the injected blood on the articular cartilage and formation of fibrous or bony ankylosis.

Temporomandibular joint dislocation following trans-oesophageal echocardiography probe insertion

Temporomandibular joint dislocation following trans-oesophageal echocardiography probe insertion

Luxation chronique bilatérale des articulations temporo-mandibulaires et syndrome de Meige

Chronic dislocation of the temporo-mandibular joint (TMJ) is rare. It occurs when an acute dislocation is left untreated, in certain situations, including severe illness, neurologic or psychiatric diseases or prolonged oral intubation. A 79 years old woman, with Meige syndrome, suffered from bilateral dislocation of the TMJ for over 1 year. Surgical repositioning of the mandibular condyles and temporal bone eminectomy were performed. At the 18 postoperative months control, no recurrence has been noted. Treatment of chronic TMJ dislocations often requires a surgical procedure. Manual reduction, even under general anaesthesia, often fails because of severe muscular spasm and periarticular fibrotic changes. The management of this disorder is still controversial. We review available surgical procedures.

Bilateral temporomandibular joint dislocation in a 26-month-old child: A rare emergency

Bilateral temporomandibular joint (TMJ) dislocation is very rare in children with only three cases previously reported in the literature. We report a case of a 26-month-old female child who presented to the emergency department of a tertiary care hospital with complaints of inability to close her mouth and drooling of saliva for the last two hours. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved with the Hippocratic method after giving analgesia and procedural sedation. The child was able to close her mouth post-reduction, and was discharged with post-TMJ reduction instructions given to the mother and with maxillofacial clinic follow up. Our report is the first case of a child presenting to the emergency department with bilateral TMJ dislocation.

Traumatic long‐standing unilateral dislocation of TMJ – a case report

AbstractThis article aims to report a rare case of traumatic long‐standing unilateral dislocation of temporomandibular joint (TMJ). To the best of our knowledge, this is the first reported case of unilateral TMJ dislocation in the paediatric population. A healthy 15‐year‐old boy presented to our department complaining of facial pain around the TMJ region. A diagnosis of unilateral left TMJ dislocation associated with myofacial pain was made based on history, clinical and radiographic examinations. Manual reduction alone was not successful to keep the reduced left condyle within the glenoid fossa. Intermaxillary fixation was needed to improve the treatment outcome. Non‐steroidal anti‐inflammatory drug was prescribed for myofacial pain. The management of this case was challenging contributed to the nature of clinical presentations.

Temporomandibular joint dislocation.

Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation.

Temporomandibular Joint Dislocation During Tracheal Intubation in a Patient With Sjogren Syndrome

Temporomandibular Joint Dislocation During Tracheal Intubation in a Patient With Sjogren Syndrome

パーキンソン病患者の顎関節脱臼に対し顎間牽引にて整復した1例

パーキンソン病患者の顎関節脱臼に対し顎間牽引にて整復した1例

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.

The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

A Novel Treatment of Recurrent Temporomandibular Joint Dislocation with Intermaxillary Fixation Using Microimplant: A Case Report

Dislocation of temporomandibular joint (TMJ) is troublesome condition which was most commonly shown far anteriorly displaced mandibular condyle to the articular eminence, thereby make it impossible to close one’s mouth. It is often referred to as ‘open lock’ in clinically. Although anatomical modification of the articular eminence through eminectomy has been considered most satisfactory and efffective treatment for managing the recurrent dislocation, it seldom performs clinically due to its invasiveness and patient’s reluctance. We thought a shortterm intermaxillary fixation could be of benefit to the patient suffering from recurrent dislocation. A 21-year-old male patient with recurrent TMJ dislocation which had developed after excessive mouth opening, was successfully treated with intermaxillay fixation using microimplant for 2 months. It is more conservative and less complicated method than eminectomy in treating recurrent TMJ dislocation. Transient intermaxillary fixation using microimplant and elastics could be one of treatment options for recurrent TMJ dislocation.

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

Ehlers Danlos syndrome in an edentulous patient with temporomandibular joint dislocation

Background: Ehlers Danlos syndrome (EDS) is heterogeneous genetic syndrome involving connective tissue. It is characterized by clinical signs of skin hyper-extensibility, delayed wound healing with atrophic scarring, joint hypermobility, easy bruising and generalized connective tissue fragility. Oral cavity is not immune to these systemic effects. Case Presentation: A 40 year old Indian male patient reported to the Department of Oral Medicine and Radiology with chief complaint of clicking in front of ear and difficulty in closing the mouth properly as his jaw seems to get stuck sometimes. The problem started about two years back when patient underwent full mouth extraction due to mobility in all teeth. On general examination certain anomalous features were observed which included hyper-extensibility of fingers of the hands and cigarette paper scars on legs and foot. The patient was completely edentulous and could touch tip of tongue to the tip of nose. Panoramic and temporomandibular joint (TMJ) limitation views were taken and MRI of TMJ was advised. Based on history and clinical features; we came to diagnosis of TMJ dislocation and Ehlers Danlos syndrome. Patient was advised to avoid wide opening of the mouth. Since the medical condition of the patient was capricious for implants prosthesis, the patient was advised to use relined complete denture. Conclusion: Ehlers Danlos syndrome is a rare genetic disorder of connective tissue. Oral manifestation and dental consideration for such cases should be well evaluated and managed appropriately.

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.

Temporomandibular joint dislocation due to atypical antipsychotic-induced acute dystonia: a case report.

Dystonia is a movement disorder that causes sustained muscle contractions, repetitive twisting movements, and abnormal postures of the trunk, neck, face, arms or legs [Fahn et al. 1987]. It may be focal, segmental (multifocal), or generalized and may also be primary or secondary based on their etiology. It may manifest as oculogyric crisis, deviation of eyes in all directions, protrusion of tongue, trismus, lock jaw, torticolis, laryngeal spasm, difficulty in speaking, facial grimacing, opisthotonus, lordosis or scoliosis and tortipelvic crisis. Drug-induced dystonia are secondary dystonias which occur commonly with drugs with antidopaminergic effects such as antipsychotics and metoclopramide [Ropper and Samuels, 2009; Fadare and Owolabi, 2009]. They reportedly arise from a drug-induced alteration of dopaminergic–cholinergic balance in the nigrostriatum (i.e. basal ganglia). Most drugs produce dystonic reactions by nigrostriatal dopamine D2 receptor blockade, which leads to an excess of striatal cholinergic output. High-potency D2 receptor antagonists are most likely to produce an acute dystonic reaction [Marsden and Jenner, 1980]. Agents that balance dopamine blockade with muscarinic M1 receptor blockade, such as atypical antipsychotics, are less likely to cause dystonic reactions [Marsden and Jenner, 1980; Volkow et al. 1998]. The incidence of acute dystonic reactions varies according to individual susceptibility, drug identity and dose of the drug. Increased age may carry less risk for the development of dystonia because of diminished numbers of D2 receptors. It occurs commonly to young males who are naive to antidopaminergic drugs [Volkow et al. 1998]. Oromandibular dystonia is one of the focal dystonias, which can be presented as jaw clenching, jaw opening or jaw deviation and leads to impaired speech and swallowing [Eken et al. 2009]. At times, oromandibular dystonia is so severe that it can cause temporomandibular joint (TMJ) dislocation. So far, few case reports have been published about TMJ dislocation due to antipsychotic medications [Ibrahim and Brooks, 1996]. Among antipsychotic-induced TMJ dislocation, case reports were mainly for high-potency first-generation antipsychotics such as haloperidol [Eken et al. 2009; Ibrahim and Brooks, 1996; Zakariaei et al. 2012]. It has been proposed that drugs such as risperidone and amisulpride which block specific receptors of serotonin (the S-HT2 receptors) and dopamine (the D2 receptors) are less likely to cause these effects [Owens, 1994]. Therefore, the present paper reports a case of oromandibular dystonia with TMJ dislocation with atypical antipsychotics such as risperidone and amisulpride.

A preliminary report on MRI findings one hour after autologous blood injection around the temporomandibular joint capsule for habitual temporomandibular joint dislocation

A preliminary report on MRI findings one hour after autologous blood injection around the temporomandibular joint capsule for habitual temporomandibular joint dislocation

The “Syringe” Technique: A Hands-Free Approach for the Reduction of Acute Nontraumatic Temporomandibular Dislocations in the Emergency Department

BackgroundThe traditional intraoral manual reduction of temporomandibular joint (TMJ) dislocations is time consuming, difficult, and at times ineffective, and commonly requires conscious sedation. ObjectivesWe describe a novel technique for the reduction of acute nontraumatic TMJ dislocations in the emergency department (ED). MethodsThis study was a prospective convenience sample population during a 3-year period at two university teaching-hospital EDs where acute nontraumatic TMJ dislocations were reduced utilizing our syringe technique. Demographics, mechanism, duration of dislocation, and reduction time were collected. Briefly, the “syringe” technique is a hands-free technique that requires a syringe to be placed between the posterior molars as they slide over the syringe to glide the anteriorly displaced condyle back into its normal anatomical position. Procedural sedation or intravenous analgesia is not required. ResultsOf the 31 patients, the mean age was 38 years. Thirty patients had a successful reduction (97%). The majority of dislocations were reduced in <1 min (77%). The two most common mechanisms for acute TMJ dislocations were due to chewing (n = 19; 61%) and yawning (n = 8; 29%). There were no recurrent dislocations at 3-day follow-up. ConclusionWe describe a novel technique for the reduction of the acutely nontraumatic TMJ dislocation in the ED. It is simple, fast, safe, and effective.

Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation

Temporomandibular joint (TMJ) dislocation is an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. This study was conducted to assess autologous blood injection to the TMJ for the treatment of chronic recurrent TMJ dislocation. Fifteen patients with bilateral chronic recurrent condylar dislocation were included in the study. Bilateral TMJ arthrocentesis was performed on each patient, followed by the injection of 2ml of autologous blood into the superior joint compartment and 1ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included a thorough history and physical examination to determine the maximal mouth opening, presence of pain and sounds, frequency of luxation, recurrence rate, and presence of facial nerve paralysis. Eighty percent of the subjects (12 patients) had a successful outcome with no further episodes of dislocation and required no further treatment at their 1-year follow-up, whereas three patients had recurrent dislocation as early as 2 weeks after treatment. Autologous blood injection is a safe, simple, and cost-effective treatment for chronic recurrent TMJ dislocation.

Analysis of MRI findings in minimum invasive treatment for habitual temporomandibular joint dislocation by autologous blood injection around the temporomandibular joint capsule

The aim of this study was to investigate magnetic resonance imaging (MRI) findings following autologous blood injection (ABI) for habitual temporomandibular joint (TMJ) dislocation. MRI was performed one hour and four and twelve weeks after ABI, revealing three types of significant findings. The first type was similar to hematoma and/or joint effusion in the articular capsule of the TMJ (type I). The second showed sporadic and diffuse T2 emphasis around the TMJ capsule (type II). The third involved a decreased range of condyle movement compared to before ABI (type III). Furthermore, we analyzed the three types of significant MRI findings.At one hour after ABI, type I was Grade 0 in 0 of 14 patients, Grade 1 in 8, Grade 2 in 2, and Grade 3 in 4. Type II was seen in 9 of the 14 cases and type III in 8. After twelve weeks, all cases of type I were Grade 0, no type II cases were evident, and type III was seen in 11 cases. Injecting autologous blood into surrounding TMJ tissues is an important factor in ABI. Minimally invasive treatment for habitual TMJ dislocation using ABI around the TMJ capsule appears to represent a very effective and safe treatment.

Conservative reduction by lever action of chronic bilateral mandibular condyle dislocation

Aims:The treatment of long-standing dislocation of the temporomandibular joint is broadly classified into open reduction and closed reduction. The current study presents a case of long-standing dislocation of the temporomandibular joint treated 3 years after dislocation. In this study, the authors evaluated the long-term outcome of conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.Methodology:Manual repositioning of temporomandibular joint dislocation lasting for 3 years in a 31-year-old woman was attempted without success; therefore, conservative reduction by lever action was carried out because the patient declined treatment under general anesthesia.Results:The treatment was discontinued after 6 days because of the subluxation of the retaining tooth. The retainer was changed from tooth to screw for intermaxillary fixation, and treatment was reinstituted. Fifteen days later, reduction was achieved and retention was started and continued for 2 months. The outcome was good, with no recurrent dislocation within 24 months of the treatment.Conclusions:Conservative reduction by lever action, involving minimally invasive treatment and little dysfunction, should be considered an optional conservative treatment.