ABSTRACT
Temporomandibular joint dislocation is described as the movement of mandibular condyle out of the fossa beyond its anatomical and functional boundaries causing pain and discomfort. It is often managed by conservative methods, but in long-standing, chronic conditions, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. Materials and Methods: This retrospective analysis involving a single center and a surgeon with 19 patients and 23 joint surgeries performed over a 10-year period. Patients who fulfilled inclusion and exclusion criteria and had earlier undergone surgical correction with hook-shaped miniplates and miniscrews fixed with or without bone grafts formed the study group. Results: In all, 12 were female (mean age, 41.9 ± 12.07 years) and the rest 9 were male (mean age, 39.8 ± 13.6 years), ranging from 32 years to 58 years. All patients had the dislocation for an average period of 19.26 ± 12.6 months before the surgery. The mean maximal mouth opening (without pain) preoperatively was 17.78 ± 2.13 mm (12–25 mm) while postoperatively it was 32.28 ± 3.17 mm (27–37 mm). There were no immediate or late surgical complications in the follow-up period that ranged from 8 to 37 months. Discussion: When proper case selection is employed and properly done, using hook-shaped miniplates with or without bone graft is more cost-effective, giving excellent short- and long-term effects. Conclusion: The results in this Indian population are very similar to that reported from other parts of the world.
ABSTRACT
<p><b>OBJECTIVE</b>This study aimed to retrospectively analyze temporomandibular joint dislocation by surgical treatment and evaluate the treatment effect.</p><p><b>METHODS</b>From May 2012 to April 2016, a total of 17 cases of temporomandibular joint dislocation were surgically treated, including 8 cases of irreducible dislocation (ID) and 9 cases of recurrent dislocation (RD). Synovial injection of sclerosing agent by arthroscope was performed in 5 cases, 9 sides; augmentation of the articular eminence by titanium plate implantation was performed in 7 cases, 12 sides; iliac bone transplantation was performed in 1 case, 1 side; Medpore implantation was performed in 3 cases, 6 sides; and eminectomy and capsular tightening were performed in 1 case, 2 sides. Follow-up was conducted 1-5 years after the operation, and the success rate statistics was obtained.</p><p><b>RESULTS</b>The cure rate of synovial injection of sclerosing agent by arthroscope was 77.8% (7/9), and the effective rate was 100%. The cure rate of titanium plate implantation was 75% (9/12), and the effective rate was 100%. The cure rates of augmentation of the articular eminence by Medpore implantation (6/6), iliac bone graft (1/1), and eminectomy (2/2) were 100%.</p><p><b>CONCLUSIONS</b>The surgical method of temporomandibular joint dislocation was selected according to the state of the patients. The postoperative recurrent patients were advised to undergo augmentation of the articular eminence by Medpore implantation, which offered a reduced chance of recurrence and relatively less injury, as well as a simple operative method.</p>
ABSTRACT
Objective:To observe the clinical effects of extraoral manual reposition approach in the treatment of acute anterior disloca-tion of temporomandibular joint. Methods:98 patients with acute anterior dislocation of temporomandibular joint were divided into 2 groups(n=49) by random digit table and treated by manual reposition through intraoral and extraoral approach respectively. The suc-cess rate, success time, patient pain during treatment, SBP, DBP, HR and patient satisfaction were evaluated respectively. Results:The success rate(95. 92%) and the patient satisfaction rate(76%) of extraoral method group were higher than those of the intraoral method group (81. 63% and 66%);success time(3. 91 ± 0. 55)s and patient pain during treatment(3. 51 ± 0. 25) in extraoral method group were less than those in the intraoral method group[(5. 57 ± 0. 51) s and (6. 6 ± 0. 21)]. The degree of changes of SBP, DBP and HR in extraoral method group were less than those in the intraoral method group(P<0. 05). Conclusion:Extraoral manual reposi-tion approach is more effective than intraoral approach in the treatment of acute anterior dislocation of temporomandibular joint.
ABSTRACT
Temporomandibular joint (TMJ) dislocation is defined as excessive forward movement of the mandibular condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. A 54 years old man attended our Emergency Department (ED) with complaints of slurred speech and inability to close his mouth after upper gastroendoscopic procedures. Lateral craniography was obtained and illustrated bilateral anterior dislocation of the patient's mandibular condyles. To confirm the diagnosis urgent radiographic imaging is required without delay as the risk of complications occurring increases as time elapses.