J Korean Assoc Oral Maxillofac Surg.  2012 Oct;38(5):305-309. 10.5125/jkaoms.2012.38.5.305.

Chronic dislocation of temporomandibular joint persisting for 6 months: a case report

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea. kimchoms@dankook.ac.kr

Abstract

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

Keyword

Temporomandibular joint; Dislocations; Condylectomy

MeSH Terms

Aged
Dislocations
Female
Head
Humans
Recurrence
Temporomandibular Joint
Transplants

Figure

  • Fig. 1 Preoperative photo and X-ray. A. The patient always presents an open mouth. B. Both condyle fell through articular eminence (arrows). C. Computed tomography view.

  • Fig. 2 Intra-operative view of the case. A. Modified preauricular incision line to expose the condyle head. B. Exposed right zygoma and condyle head. C. The right condyle head was resected. D. The resected condyle was polished by round bur. E. When the mouth opened, the condyle head was positioned at the same level of articular eminence. F. When the mouth closed, the condyle head sat on the condyle fossa.

  • Fig. 3 Resected left condyle head and right condyle head.

  • Fig. 4 The postoperative panoramic view revealed bilateral condylectomy (arrows).


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