Surgical reconstruction of the temporomandibular joint for chronic subluxation and dislocation

Modifications to Norman's procedure for hypermobility of the TMJ

“…8 After two years Raja Kummoona achieved 100% success in all 7 cases of hypermobility with average postoperative mouth opening of 32.5 mm. 7 A.M. Medra et al observed one recurrence out of 60 cases operated. The average postoperative mouth opening after 1 year was 42 mm.…”

“…The temporal fascial flap is easy to rotate, prevents laxity of the capsule, reinforces the temporomandibular ligament and further induces scar formation. 7 Pterygoid disjunction is an effective method to reduce pain associated with internal derangement of TMJ associated with hypermobility. It reduces the effective length/strength of lateral pterygoid muscle and thereby providing rest to the joint.…”

A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases

“…The surgical techniques adopted for prolonged cases in the present report were condylectomy, inverted L-shaped ostectomy, oblique ramus osteotomy and vertical subsigmoid osteotomy. Some workers have reported anterior open bite deformity with bilateral condylectomy 1,9,10 . An oblique or vertical ramus osteotomy to reposition the mandible may cause impingment of the coronoid on the condylar processes unlike the inverted L-shaped osteotomy where such encroachment is avoided due to retention of the relative positions of condylar and coronoid processes.…”

“…Subsequently, the facial profile changes while the ligaments around the joint often stretch with intra-articular effusion, causing severe discomfort and difficulty with speech and mastication from muscle spasms and joint pain 1,5 . While subluxation or habitual luxation refers to excessive abnormal excursion of the condyle secondary to flaccidity and laxity of the joint capsule, recurrent dislocation is characterized by a condyle that slides over the articular eminence, catches briefly beyond the eminence and then returns to the fossa 1,4,10,21 . The latter type occurs repeatedly and is often associated with neurogenic dislocation where there is increased tone of the masticatory muscles.…”

Arthroscopic electrothermal capsulorrhaphy for the treatment of recurrent temporomandibular joint dislocation

“…[73][74][75][76][77][78][79] Tethering techniques have been described using wire, 80 fascia lata, 81 sutures, 14,21,62,82 and temporalis fascia. [83][84][85][86] Another method advocated is producing an induced arthrofibrosis by the injection of a sclerosing solution [87][88][89][90] or autologous blood. [91][92][93][94][95][96] The aim of this study is to review the safety and efficiency of arthroscopic electrothermal capsulorrhaphy for the treatment of RTD.…”