Recurrent Temporomandibular Joint Dislocation Research Articles

Ethoxysclerol injection into the posterior ligament under single puncture arthroscopy for the treatment of recurrent temporomandibular joint dislocation: a novel technique

The pathogenesis of recurrent chronic dislocation of the temporomandibular joint has been attributed to multiple factors, such as hyperlaxity of the soft tissues or alterations in the size of the temporal eminence. When there are no bone alterations, the injection of sclerosing solutions is an effective treatment that can be performed using a blind technique or with arthroscopy. This study presents an innovative technique for injecting ethoxysclerol into the posterior ligament through single puncture arthroscopy. This approach offers a safe and effective alternative for surgeons without experience in high-complexity arthroscopy who want to ensure precise injection of the agent into the desired anatomical areas.

Increased Prevalence of Generalized Joint Hypermobility Observed in Patients With Recurrent Temporomandibular Joint Dislocation

Generalized joint hypermobility (GJH), determined by the Beighton score, is a fundamental part of diagnosing benign joint hypermobility syndrome (BJHS), which may also present extra-articular manifestations, and is determined by the Brighton criteria. This study was designed to investigate whether there is an association between recurrent temporomandibular joint (TMJ) dislocation and these disorders. A retrospective cross-sectional study was conducted. Hospital-based patients with a history of recurrent TMJ dislocation were compared to population-based patients that did not experience TMJ dislocations or any other TMJ disorders. Age and sex matching were performed between the study groups. All subjects reached the age of skeletal maturity. A history of recurrent TMJ dislocations. Measurements of Beighton score (range from 0 to 9 with a score of ≥ 4 indicating GJH) and correspondence to the Brighton criteria (with at least two "major" criteria or one "major" criterion plus two "minor" criteria or four "minor" criteria indicating BJHS). Included age and sex. Mann-Whitney U-test for continuous variables and the χ2 test or Fisher's exact test for categorical variables. Statistical significance was set at P<.05. A total of 68 participants were included, of whom 34 patients presented with recurrent TMJ dislocations compared with a control population of 34. The Mean participants were 31.35±8.06years, and 29.4% (n=20) were males. Of the dislocation group, 16 (47.0%) patients had a Beighton score of 4 or higher. The Beighton sum score was significantly higher, with a TMJ dislocation group mean score of 3.06±2.8, compared with a control score of 0.82±1.1 (P=.001). A total of 58.8% (n=20) of the TMJ dislocation group participants met the Brighton criteria versus none (0.0%) of the control group (P=.001). We found an association between recurrent TMJ dislocation and GJH. An association with BJHS was also found, based mainly on articular manifestations. Early detection of these disorders in patients suffering from recurrent TMJ dislocation may help identify individuals at increased risk for joint instabilities and allow the implementation of appropriate preventive management strategies.

ELASTIC TRACTION TREATMENT FOR THE MANAGEMENT OF CHRONIC DISLOCATION OF BILATERAL MANDIBULAR CONDYLE - A REPORT OF 2 CASES

Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. Temporomandibular joint (TMJ) dislocation is a common problem faced in outpatient setting by maxillofacial surgeons and dentist. Chronic recurrent TMJ dislocation is a challenging situation to manage. Though the chronic dislocation of bilateral condylar of mandible is not very common, but if it occur to the patient, there is no fixed noninvasive protocols to manage it. This study is an attempt to establish the noninvasive treatment protocols for further studies with larger sample size.

Autologous blood versus Platelet rich plasma (PRP), pericapsular injection in the treatment of chronic recurrent temporomandibular joint dislocation

Autologous blood versus Platelet rich plasma (PRP), pericapsular injection in the treatment of chronic recurrent temporomandibular joint dislocation

Treatment of Recurrent Dislocation of the Temporomandibular Joint with the Injection of Autologous Blood in Superior Joint Space with and without Pericapsular Tissue: An Experience at Tertiary Care Hospital of Peshawar

Background: Recurrent TMJ (temporomandibular joint) dislocation is a condition characterized by frequent dislocation events. Recurrent TMJ dislocation may be treated using a variety of techniques, including conservative therapy and surgical treatments. Objective: The objective of the study was to assess the effectiveness of treatment of recurrent dislocation of the temporomandibular joint with injection of autologous blood in superior joint space with and without pericapsular tissue Methodology: The current study was prospective was carried out at the Kabir Medical College, Gandhara University, Peshawar for duration of one year from June 2021 to July 2022. The patients were categorized into group A and B, each having 50 patients. In group A patients the autologous blood was injected in superior joint space while in group B, autologous blood was injected in pericapsular tissue. The average reduction in mouth opening was recorded in both the groups. All the data analysis was performed by using IBM SPSS version 23. Results: In group A patients, a mean (±sd) decrease in mouth opening of 3.30 (0.77) mm was observed (p=0.001) while a mean (±sd) decrease in mouth opening of 4.56 (0.72) mm was observed in group B patients (p=0.001). Dislocation recurrence was observed in 4 (57.14%) patients in group A while in group B, dislocation recurrence was observed in 3 (42.86%) patients (p=0.001). Conclusion: Our study concludes that management of recurrent dislocation of TMJ with injection of autologous blood was safe, efficient, simple and economic procedure. Patients with recurrent TMJ dislocation should be encouraged to use autologous blood injection for their treatment. Keywords: Recurrent; Temporomandibular joint dislocation; Autologous blood injection

Recurrent Temporomandibular Joint Dislocation Due to Antiemetic Induced Acute Dystonia: A Case Report

Introduction: Drug-induced acute dystonic reaction is a common presentation to emergency department. 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. In this paper, we presented an adult patient with recurrent temporomandibular joint dislocation due to metoclopramide use.&#x0D; Case Report: A 21-year-old female patient came to the emergency department with the complaints of inability chew and swallow, difficulty in speaking, pain at right temporomandibular region that started a few hours ago. On physical examination, she was having dystonia of the right mandibular region and left posterior servikal region and no dystonia at other parts of the body. The patient was diagnosed with metoclopramide-induced acute dystonia. She was treated with intravenous anticholinergic.&#x0D; Conclusion: Metoclopramide is an antiemetic drug that can cause serious adverse events such as acute dystonic reaction. Among these side effects are oromandibular dystonias, which may lead to TMJ dislocation. Physicians and other healthcare professionals working in the emergency department should be familiar with such side effects.

Are There Cephalometric Measurements Associated With Recurrent Temporomandibular Joint Dislocation?

Several theories have been proposed for the etiology of recurrent temporomandibular joint (TMJ) dislocation. The purpose of the present study was to determine whether there are cephalometric measurements associated with this phenomenon. A retrospective case-control study was performed, which included individuals who suffered from recurrent TMJ dislocation and a control group composed of patients who suffered from unrelated odontogenic infections and did not have any TMJ disorder. All the patients were referred to the Department of Oral and Maxillofacial Surgery at the Hadassah Medical Center between 2010 and 2021 and underwent multidetector computed tomography of the jaws. The main predictor variable was a history of recurrent TMJ dislocations. Covariates included age and gender. The primary outcome variable was a set of 11 cephalometric measurements. A statistical analysis was performed with the Mann-Whitney U-test for continuous variables and the Chi-squared test or Fisher's exact test for categorical variables, followed by a logistic regression model. Multiple comparisons were made by using the Benjamini-Hochberg method. The total 32 subjects included in the analysis consisted of 16 patients presenting with bilateral recurrent TMJ dislocation and a control population of 16 patients. The mean age was 34.19±12.7years, 40.6% (n=13) were males, with no statistically significant differences between the groups. An increased overbite was detected in the TMJ dislocation group, whereas over-jet was greater among the control group, although not statistically significant. Skeletal ratio analysis showed that the TMJ dislocation group had a statistically significantly greater Articulare-Gonion length (46.96mm±5.2mm vs 43.01mm±5.3mm; P=.043) and a lower angle of occlusal plane to Frankfort horizontal (4.56o±5.7o vs 9.60o ± 3.9o; P=.007), Y-axis (58.01o±4.9o vs 61.72o ± 3.3o; P=.019), and Frankfurt mandibular plane (24.10o±6.1o vs 30.14o ± 4.7o; P=.004). Specific cephalometric measurements are associated with recurrent TMJ dislocation. The high Articulare-Gonion length and the low rates of occlusal plane to Frankfort horizontal angle, Y-axis, and Frankfurt mandibular plane found in the study population suggest that the resultant vertically oriented elevator muscles may be considered a predisposing factor for this phenomenon.

Assessment of Maximal Incisal opening using autogenous Inlay Assessment of Maximal Incisal opening using autogenous Inlay Eminoplasty Technique For Treatment Of chronic recurrent Eminoplasty Technique For Treatment Of chronic recurrent temporo mandibular joint Dislocation

Purpose: Different surgical protocols have been introduced for eminence augmentation for treatment of recurrent temporomandibular joint dislocation, The aim of this study is to assess maximal incisal opening (MIO) using inlay (sandwich osteotomy) autogenous block augmentation harvested from patient’s symphesis for more stable condylar movements . Methods: five patients were treated in this study (10 joints) with bilateral autogenous inlay block bone grafting technique, each autogenous cortico-cancellous bone block was harvested from chin and wedged at the created defect of the eminence through a green stick fracture to increase its height . Results: The follow up period ranged from six months to two years to access the maximal incisal opening (MIO). the mean preoperative maximal incisal opening was 45.8mm and that of the postoperative was 32.3 mm . One patient reported postoperative slight unilateral edema and pain that gradually diminishes after one month postoperative.another patient showed intraoperative condylar dislocation that was treated with masseter scarification. Conclusion: autogenous block interpositional eminoplasty technique is a reliable procedure for management of antero-medial recurrent condylar dislocation.

Ultrasound-guided lateral pterygoid muscle botulinum toxin: an injection for recurrent temporomandibular joint dislocation in a brain injury patient.

Botulinum toxin type A (BTX-A) injection using nerve stimulation or electromyography for recurrent temporomandibular joint (TMJ) dislocation has been reported for several years. However, using the available equipment like a nerve stimulator or an electromyograph is uncommon, and ultrasound guidance is convenient and requires no additional resources. In this report, we used ultrasound as a tool to achieve BTX-A injections in a patient with a traumatic brain injury to treat her TMJ dislocation. One week after the injections, she had no more dislocation. She remained symptom free during the 3months of follow-up, and her clinical symptoms improved without significant complications. This is the first report using ultrasound guidance for BTX-A injections to treat recurrent TMJ dislocation. This treatment is an effective and safe technique that could be performed timely and locally without referral to a center with electromyography facilities.

Glenotemporal osteotomy with bone grafting versus Dautrey's procedure for the management of chronic recurrent temporomandibular joint dislocation and hypermobility: A retrospective study

AbstractAimThe aim of the current study was to retrospectively compare Dautery's procedure and glenotemporal osteotomy in the treatment of chronic recurrent temporomandibular joint dislocation and hypermobility.Materials and Methods28 patients presented with chronic recurrent dislocation of the TMJ during the period of the study. Three cases were omitted as they were operated using surgical techniques other than Dautrey's procedure or glenotemporal osteotomy. Another two cases were excluded because of incomplete data.Results23 patients, 18 females and 5 males were included in this study. Group I included nine patients who had Dautrey's procedure and group II included 14 patients for whom glenotemporal osteotomy and bone grafting was performed. The mean age was 26.2 years (ranging from 14.5 to 54 years). The mean postoperative mouth opening in group I was 29 mm (ranging from 23 to 36 mm). The mean postoperative mouth opening in group II was 28.5 mm (ranging from 21 to 41 mm). Statistical analysis failed to reveal a significant difference in complications between both groups.ConclusionsDautrey's procedure and glenotemporal osteotomy are valuable surgical options in the treatment of chronic TMJ dislocation. The choice of the procedure may be left to the operator's preference.

Comparison of autologous blood prolotherapy and 25% dextrose prolotherapy for the treatment of chronic recurrent temporomandibular joint dislocation on the basis of clinical parameters: A retrospective study.

Prolotherapy is a nonsurgical regenerative injection technique and effective treatment method for the treatment of temporomandibular joint (TMJ) dislocation. Autologous blood and dextrose are commonly used agents for prolotherapy and the aim of this study is to compare the autologous blood injection prolotherapy and 25% dextrose prolotherapy for the treatment of chronic recurrent TMJ dislocation. This is a retrospective cohort study of 20 patients with chronic recurrent TMJ dislocation who were treated by either autologous blood (Group A) or 25% dextrose Prolotherapy (Group B). After prolotherapy, the patients were kept on follow-up and evaluated for maximum mouth opening (MMO), pain at visual analog scale (VAS), mandibular movements, frequency of dislocation, and TMJ sound. The collected data were then statistically analyzed. Group A showed better results in terms of reduction in MMO, mandibular movements as compared to Group B, and a statistically significant difference was found starting from 2 weeks post prolotherapy till 6 months follow-up. Whereas group B showed better results regarding reduction in pain intensity on VAS Scale at all follow-up visits. No statistically significant difference was found between both groups regarding reduction in the frequency of dislocation and TMJ sounds. Both autologous and dextrose prolotherapy gives promising results for the treatment of recurrent TMJ dislocation, however, regarding reduction in MMO and improvement in lateral and protrusive mandibular movements, autologous blood gave better results whereas 25% Dextrose was found to be more effective in terms of reduction of pain in recurrent TMJ dislocation cases.

Evaluation of Intermaxillary Fixation (IMF) Screw Therapy with Craniomandibular Index Analysis for Chronic Recurrent Dislocation in the Temporomandibular Joint.

Temporomandibular joint (TMJ) hypermobility is classified as a subluxation, complete (luxation), unilateral, or bilateral, acute, chronic protracted, or chronic recurrent dislocation. This controlled randomized clinical study aims to evaluate the effectiveness of intermaxillary fixation (IMF) screw application and autologous blood injections in the treatment of chronic recurrent dislocation of TMJ in comparison with the placebo group. The patients who were admitted to the Faculty of Dentistry of the Atatürk University between October 2018 and January 2020 were evaluated. Three hundred patients diagnosed with bilateral chronic recurrent dislocation of TMJ based on clinical findings and radiographs were included in the study. The patients were randomly divided into three groups according to the evaluation criteria. Group 1 received IMF, group 2 received autologous blood injection, and group 3 (placebo group) received an intraarticular saline injection. The results of the patients who received IMF, autologous blood injection, and saline injection were evaluated by the craniomandibular index. The IMF group showed significant improvement after 1 month and 6 months (P < 0.001), while the patients who received autologous blood injection and saline injection showed no significant improvement (P > 0.05). The data were analyzed with IBM SPSS V23. The significance level was P < 0.05. In our study, the IMF gave the best results among all the study groups. The IMF technique can be used in patients with protracted chronic recurrent dislocation in whom autologous blood injection has failed.

A technique to verify adequacy of eminectomy for recurrent temporomandibular joint dislocation

Recurrent dislocation of the temporomandibular joint (TMJ) can be highly debilitating, especially if the dislocation cannot be reduced by the patient. Despite being regarded as a ‘gold standard’ or ‘salvage’ procedure for refractory TMJ dislocations, complete mediolateral removal of the articular eminence can still lead to recurrences. A technique aimed at intraoperatively verifying the adequacy of osseous reduction in order to minimize the risk of re-dislocation of the TMJ is described.

Recurrent TMJ Dislocation in a Child: A Case Report and Discussion

Temporomandibular joint (TMJ) dislocation demonstrate a displacement of the mandibular condyle from it functional position within the glenoid fossa and articular eminence. TMJ dislocation is an acute episode can be transformed into chronic dislocation after multiple repeated episodes. Oral surgeon is frequently called for the management of recurrent TMJ dislocation in adults. In pediatric population, TMJ dislocation sometimes caused by trauma or other than trauma related to wide opening of the mouth during vomiting, yawning and dental procedures considerably under general anesthesia. A 3-year-old baby girl came to Emergency department with a complaint of open mouth for the last 6 hours. Initial examination was carried out and patient was sent for CT-Scan. CT-Scan reported an asymmetric soft tissue density mass in retropharyngeal area at the level of C1 and C2, showing more bulk on right side. Some subtle radiolucency are also identified within the mass. The possibility of a low-density foreign body or retropharyngeal abscess could not be entirely excluded. A quick examination under anesthesia (EUA)was performed to relieve the patient from the abscess/growth. During EUA, they did not find any growth or collection or pus. The patient was sent to oral and maxillofacial surgeon, on initial examination and previous CT Scan findings, TMJ dislocation was diagnosed. In order to completely examine the patient, reduction of the jaw was attempted on chair side. This was achieved by digital manipulation with little effort and the baby’s jaw was secured with Barton’s bandage to prevent repeated dislocation. She continued tablet baclofen for 6 months as prescribed by the pediatrician. KEYWORDS: Temporomandibular Joint (TMJ), Recurrent dislocation, pediatric

Efficacy of Autologous Blood Injection for Treatment of Chronic Recurrent Temporo-mandibular Joint Dislocation

Efficacy of Autologous Blood Injection for Treatment of Chronic Recurrent Temporo-mandibular Joint Dislocation

Autologous blood injection for the treatment of chronic recurrent temporomandibular joint dislocation in neurological disorder - A case report

Autologous blood injection (ABI) into the articular cavity, It is one of the treatments for recurrent temporomandibular joint dislocation, was recently reintroduced, here we present a case report of the management of recurrent temporomandibular joint dislocation by Autologous blood injection (ABI) in a 45 -year-old neurologically disabled female. After the treatment, the left condylar process had settled just beneath the articular tubercle, the dislocation had improved, the patient was able to close her mouth & patient was followed on 3rd day, 15th day, 1 month, 3rd month, 6th month, 1 year for 1 year. Keywords: Autologous blood injection, ABI, Temporomandibular joint dislocation, TMJ.

Recurrent temporomandibular joint dislocation secondary to epilepsy

An 84-year-old incommunicable woman with a history of left cerebral haemorrhage presented with five episodes of temporomandibular joint (TMJ) dislocation in 1 month. Each dislocation was associated with an ocular...

Management Strategy for Chronic Recurrent Temporomandibular Joint Dislocation: A Prospective Study.

Various approach strategies have been followed for management of temporomandibular joint (TMJ) dislocation. In this study, a total of 12 patients (21 TM joints) with chronic recurrent TMJ dislocations were managed surgically by articular eminectomy due to unsatisfactory outcomes of conservative management methods. An improvement in pain, range of jaw movements and maximal mouth opening was achieved in 10 patients (83.3%).

A newly designed condylar block plate for treatment of recurrent temporomandibular joint dislocation

ObjectivesThis article evaluated a new technique for the treatment of recurrent temporomandibular joint (TMJ) dislocation through augmentation of the articular eminence using a newly designed plate called condylar block plate. MethodsWe developed a new titanium plate called condylar block plate (condylar anti-dislocation plate), composed of three main parts: block, plate, and neck parts. The primary function is achieved by the block part, which is 5 mm thickness, 7 mm height, and 10 mm width. It is fixed to the zygomatic arch through the plate part. The purpose of the plate achieved by augmenting the articular eminence. We treat Eight patients diagnosed with chronic recurrent TMJ dislocation by using the newly designed condylar block plate. ResultsAll cases had a successful outcome with no recurrences and required no further treatment at their 12 months follow-up. ConclusionThis procedure has proven to be safe and straightforward for the treatment of chronic recurrent TMJ dislocation.

Assessment of patient-specific titanium onlay versus autogenous inlay eminoplasty technique for treatment of recurrent temporomandibular joint dislocation: a randomized clinical trial.

Various procedures have been adopted for eminence augmentation for treatment of recurrent temporomandibular joint dislocation. The aim of this study is to assess maximal incisal opening (MIO) using a custom-made titanium implant versus inlay autogenous augmentation from the patient's chin for more stable condylar movements. Ten patients were treated in this study (20 joints) five patients with bilateral patient-specific titanium onlay implant and five for autogenous inlay grafting technique; each implant in the study group was virtually designed using a specific software and milled from titanium grade V blocks, then fixed with mini screws at the lateral aspect of the zygomatic arch while in the control group, autogenous corticocancellous bone block was harvested from the chin and wedged at the created defect of the eminence to increase its height. The follow-up period ranged from 6 months to 1 year to access the maximal incisal opening (MIO). The mean preoperative maximal incisal opening was 47.8 mm and that of the postoperative was 33.2 mm in the study group and 35.4 mm in the control group, respectively. One patient reported postoperative slight unilateral edema and pain that gradually diminishes after 1 month postoperative. No statistical difference between both groups p value 0.3.