IntroductionA dislocation of the temporomandibular joint represents three percent of all reported dislocated joints.The treatment entails reduction of the deformity and this can often be achieved in a ward setting.Case presentationWe present the case of a 29-year-old Caucasian man with a non-traumatic bilateral anterior temporomandibular joint dislocation. Following several unsuccessful attempts, due to both inadequate patient analgesia and sedation, joint reduction had to be performed in theatre with the patient under general anesthesia.ConclusionThis case highlights the importance of providing the patient with adequate analgesia and sedation when attempting the reduction of temporomandibular joint dislocations.

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Introduction: Eminectomy is the physical removal of the articular eminence to enable free movement of the condyle. The primary indication is to treat recurrent dislocation, although in the past it has been used for non-reducing disc displacement without reduction (NDDR). The established contraindication to the procedure is pneumatisation of the articular eminence or tubercle. Determining the success rates of eminectomies from previous papers are hampered by the lack of baseline objective measures needed to improve assessment of treatment outcomes. Methodology: A retrospective case series was conducted, in which written and computerised hospital records and images were analysed from 2007 to 2014, using a minimum data set developed by our unit to assess outcomes. These included indication for procedure, frequency of dislocation, interincisal distance, pre-operative imaging and objective pain scoring. Results: Twenty of twenty-eight (71%) patients receiving an eminectomy conformed to the minimum data set. Pain improvement was demonstrated in 60% of patients with both recurrent dislocation and NDDR. Complications occurred in 24% of eminectomies, all of which were temporary. Conclusions: Eminectomy is a safe and effective procedure for management of chronic temporomandibular joint dislocation in wellselected cases. However, the results were less predictable with NDDR. The recording of specific clinical information is required to improve comparing outcomes and we would recommend the use of a proforma such as one utilised in our study. There was no evidence that pneumatisation of the eminence was related to an adverse clinical outcome but further evidence is required to question this as a contraindication to eminectomy.

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Summary Supraglottic airway devices are commonly used to manage the airway during general anaesthesia. There are sporadic case reports of temporomandibular joint dysfunction and dislocation following supraglottic airway device use. We conducted a prospective observational study of adult patients undergoing elective surgery where a supraglottic airway device was used as the primary airway device. Pre‐operatively, all participants were asked to complete a questionnaire involving 12 points adapted from the Temporomandibular Joint Scale and the Liverpool Oral Rehabilitation Questionnaire. Objective measurements included inter‐incisor distance as well as forward and lateral jaw movements. The primary outcome was the inter‐incisor distance, an accepted measure of temporomandibular joint mobility. Both the questionnaire and measurements were repeated in the postoperative period and we analysed data from 130 participants. Mean (SD) inter‐incisor distance in the pre‐ and postoperative period was 46.5 (7.2) mm and 46.3 (7.5) mm, respectively (p = 0.521) with a difference (95%CI) of 0.2 (−0.5 to 0.9) mm. Mean (SD) forward jaw movement in the pre‐ and postoperative period was 3.6 (2.4) mm and 3.9 (2.4) mm, respectively (p = 0.018). Mean (SD) lateral jaw movement to the right in the pre‐ and postoperative period was 8.9 (4.1) mm and 9.1 (4.0) mm, respectively (p = 0.314). Mean (SD) lateral jaw movement to the left in the pre‐ and postoperative period was 8.8 (4.0) mm and 9.3 (3.6) mm, respectively (p = 0.008). The number of patients who reported jaw clicks or pops before opening their mouth as wide as possible was 28 (21.5%) vs. 12 (9.2%) in the pre‐ and postoperative period, respectively (p < 0.001) with a difference (95%CI) of 12.3% (6.7–17.9%). There was no significant difference in the responses to the other 11 questions or in the number of patients who reported pain in the temporomandibular joint area postoperatively. No clinically significant dysfunction of the temporomandibular joint following the use of supraglottic airway devices in the postoperative period was identified by either patient questionnaires or objective measurements.