Analysis of Temporomandibular Joint Dislocations in A Province of Türkiye

Year 2025, Volume: 8 Issue: 1, 7 - 11, 19.03.2025

Yenal Karakoç , Ömer Kaçmaz , Öner Avınca , Mahmut Tas

https://doi.org/10.36516/jocass.1582110

Abstract

ABSTRACT
Background: It is extremely important to analyze the etiology of TMJ dislocation, take the correct history, and diagnose the signs and symptoms correctly so that the treatment can be performed as soon as possible without delay.
Objectives: In this study, we aimed analysis of the patient's management and applicability to the emergency department due to temporomandibular joint displacement with the literature.
Material and methods: In our single-center retrospective study, all patients who applied to the emergency department of our hospital between January 2016 and April 2022 due to mandibular dislocation were initially included in the study.
Results: A total of 67 [n=67] patients who applied to our emergency clinic due to jaw dislocation were recorded. 31 [46,3%] of all patients were evaluated as first-time dislocations and 36 [53,7%] with recurrent dislocations. When we evaluated the jaw dislocations according to the gender of the patients, we observed that the female gender was more affected in both first-time and recurrent dislocation patients. Bilateral dislocations were the most common in patients with first-time jaw dislocation 29 [93.5%]] as well as in patients with recurrent dislocations 34 [94.4%]]. When we evaluated the groups, it was found that traumatic causes 19 [61.3%]] were more common in first-time jaw dislocations, and non-traumatic causes were more common in recurrent dislocations 27 [75%]].
Conclusion: Although emergency physicians rarely encounter TMJ dislocation, they need to know the treatment options and the importance of early reduction to ensure patient comfort and joint function.

Keywords

TMJ dislocations, manual reduction, Emergency Department

References

• 1.Sharma D, Khasgiwala A, Maheshwari B, Singh C, Shakya N. Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review. Dent Traumatol. 2017;33[1]:64-70 https://doi.org/10.1111/edt.12282
• 2.Hillam J, Isom B. Mandible Dislocation. [Updated 2021 Jul 28]. In: Stat Pearls [Internet]. Treasure Island [FL]: Stat Pearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549809/
• 3.Sharma NK, Singh AK, Pandey A, Verma V, Singh S. Temporomandibular joint dislocation. Natl J Maxillofac Surg. 2015 6[1]:16-20. https://doi.org/10.4103/0975-5950.168212
• 4.Liddell A, Perez DE. Temporomandibular joint dislocation. Oral Maxillofac Surg Clin North Am. 2015 ;27[1]:125-36. https://doi.org/10.1016/j.coms.2014.09.009
• 5.Gambling DR, Ross PL. Temporomandibular joint subluxation on induction of anesthesia. Anesth Analg. 1988;67[1]:91-2. https://doi.org/10.1213/00000539-198801000-00021
• 6.Lacy PD, Lee JM, O'Morain CA. Temporomandibular joint dislocation: an unusual complication of upper gastrointestinal endoscopy. Am J Gastroenterol. 2000 Dec;95[12]:3653-4. https://doi.org/10.1016/S0002-9270(00)02189-4
• 7.Mangi Q, Ridgway PF, Ibrahim Z, Evoy D, Ridgway RF. Dislocation of the mandible. Surg Endosc. 2004 Mar;18[3]:554-6. https://doi.org/10.1007/s00464-003-4223-z
• 8.Martins WD, Ribas Mde O, Bisinelli J, França BH, Martins G. Recurrent dislocation of the temporomandibular joint: a literature review and two case reports treated with eminectomy. Cranio. 2014;32[2]:110-7 https://doi.org/10.1179/0886963413Z.00000000017
• 9.Kai S, Kai H, Nakayama E, et al. Clinical symptoms of open lock position of the condyle. Relation to anterior dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol 1992; 74:143. https://doi.org/10.1016/0030-4220(92)90372-W
• 10.Pillai S, Konia MR. Unrecognized bilateral temporomandibular joint dislocation after general anesthesia with a delay in diagnosis and management: a case report. J Med Case Rep. 2013;7:243 https://doi.org/10.1186/1752-1947-7-243
• 11.Oliphant R, Key B, Dawson C, Chung D. Bilateral temporomandibular joint dislocation following pulmonary function testing: a case report and review of closed reduction techniques. Emerg Med J. 2008;25[7]:435-6. https://doi.org/10.1136/emj.2007.055038
• 12.El Bouazzaoui A, Labib S, Derkaoui A, Adnane Berdai M, Bendadi A, Harandou M. Dislocation of temporo-mandibular joint an uncommon circumstance of occurrence: vaginal delivery. Pan Afr Med J. 2010;5:23.
• 13.Prechel U, Ottl P, Ahlers OM, Neff A. The Treatment of Temporomandibular Joint Dislocation. Dtsch Arztebl Int. 2018;115[5]:59-64 https://doi.org/10.3238/arztebl.2018.0059
• 14.Papoutsis G, Papoutsi S, Klukowska-Rötzler J, Schaller, B., et al. Temporomandibular joint dislocation: a retrospective study from a Swiss urban emergency department. Open access emergency medicine: 2018:10; 171-6. https://doi.org/10.2147/OAEM.S174116
• 15.Hoard MA, Tadje JP, Gampper TJ, Edlich RF. Traumatic chronic TMJ dislocation: report of an unusual case and discussion of management. J Craniomaxillofac Trauma. 1998 Winter;4[4]:44-7.
• 16.Ozcelik TB, Pektas ZO. Management of chronic unilateral temporomandibular joint dislocation with a mandibular guidance prosthesis: a clinical report. J Prosthet Dent. 2008;99[2]:95-100. https://doi.org/10.1016/S0022-3913(08)60024-4
• 17.Undt G, Kermer C, Piehslinger E, Rasse M. Treatment of recurrent mandibular dislocation, Part I: Leclerc blocking procedure. Int J Oral Maxillofac Surg. 1997;26[2]:92-7. https://doi.org/10.1016/S0901-5027(05)80634-4
• 18.Shorey CW, Campbell JH. Dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89[6]:662-8 https://doi.org/10.1067/moe.2000.106693
• 19.Lovely FW, Copeland RA. Reduction eminoplasty for chronic recurrent luxation of the temporomandibular joint. J Can Dent Assoc. 1981;47[3]:179-84.
• 20.Zweifel DF, Pietramaggiori G, Broome M. Videos in clinical medicine. Repositioning dislocated temporomandibular joints. N Engl J Med. 2014;370[6]:e9. https://doi.org/10.1056/NEJMvcm1301200
• 21.Sharma D, Khasgiwala A, Maheshwari B, Singh C, Shakya N. Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review. Dent Traumatol. 2017;33[1]:64-70. https://doi.org/10.1111/edt.12282
• 22.Totten VY, Zambito RF. Propofol bolus facilitates reduction of luxed temporomandibular joints. J Emerg Med. 1998;16[3]:467-70. https://doi.org/10.1016/S0736-4679(98)00018-3
• 23.Young AL, Khan J, Thomas DC, Quek SY. Use of masseteric and deep temporal nerve blocks for reduction of mandibular dislocation. Anesth Prog. 2009;56[1]:9-13. https://doi.org/10.2344/0003-3006-56.1.9
• 24.Schuknecht B, Graetz K. Radiologic assessment of maxillofacial, mandibular, and skull base trauma. Eur Radiol. 2005;15[3]:560-8. https://doi.org/10.1007/s00330-004-2631-7
• 25.Lowery LE, Beeson MS, Lum KK. The wrist pivot method, a novel technique for temporomandibular joint reduction. J Emergency Med. 2004 ;27[2]:167-70. https://doi.org/10.1016/j.jemermed.2004.03.007
• 26.Chen YC, Chen CT, Lin CH, Chen YR. A safe and effective way for reduction of temporomandibular joint dislocation. Ann Plastic Surg. 2007;58[1]:105-8. https://doi.org/10.1097/01.sap.0000232981.40497.32
• 27.Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head & Face Medicine, 2011;7, 1-9. https://doi.org/10.1186/1746-160X-7-10
• 28.Stark TR, Perez CV, Okeson JP. Recurrent TMJ Dislocation Managed with Botulinum Toxin Type A Injections in a Pediatric Patient. Pediatric Dent. 2015;37[1]:65-9.
• 29.Chhabra S, Chhabra N, Gupta P. Recurrent Mandibular Dislocation in Geriatric Patients: Treatment and Prevention by a Simple and Non-invasive Technique. J Maxillofacial Oral Surg. 2015;14[Supply 1]:231-4. https://doi.org/10.1007/s12663-012-0454-7
• 30.Jaisani MR, Pradhan L, Sagtani A. Use of cervical collar in temporomandibular dislocation. J Maxillofacial Oral Surg. 2015;14[2]:470-1. https://doi.org/10.1007/s12663-013-0505-8