Temporomandibular joint dislocation: experiences from Zaria, Nigeria

Abstract

ObjectivesDislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment.Materials and MethodsA seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records.ResultsIn all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications.ConclusionTemporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected.

The Treatment of Temporomandibular Joint Dislocation

“…Temporomandibular joint dislocation of the nonfractured mandible most commonly involves bilateral dislocation of the mandibular heads anterior to the articular tubercles without spontaneous reduction (Figure 1) (10). Typically, younger adults between 25 and 45 years of age are affected (2,11,12).…”

“…Patients without acute facial trauma who for the first time experience a temporomandibular joint dislocation can be diagnosed based on medical history (8,10,16,19). Especially in older patients with multimorbidity, temporomandibular joint dislocation may initially be overlooked as symptoms are milder and the ability to communicate is often limited (5).…”

Treatment of temporomandibular joint luxation: a systematic literature review

“…Although a retrospective study by Agbara et al at a university hospital in Nigeria reported that TMJ luxation was associated with yawning, higher age, and male gender, in general, the TMJ joints are more flexible in women and therefore more likely to luxate [6]. However, the incidence of TMJ luxation is low; two medical emergency departments, with 100,000 annual visits combined, reported an average of 5.3 cases annually of TMJ luxation over a period of 7 years [7].…”

Anterior dislocation of the temporomandibular joint: a simplified non-traumatic manual technique

“…It can be classified based on symmetry (uni-or bilateral), position of the mandibular condyle (anterior, posterior, medial, lateral, or superior), number of occurrences (recurrent or non-recurrent), time of presentation (acute or chronic), and etiology (traumatic or spontaneous [6]. Spontaneous acute bilateral anterior mandibular dislocation (AMD) is the most frequent type [2,[6][7][8][9].…”

“…Everyday situations such as yawning, laughing, extreme mouth opening, dental procedures, vomiting, and oral sex, can trigger anterior dislocation of the mandibular condyle in patients with predisposing factors [2]. Morphological bone alterations of the mandibular condyle or articular eminence of the temporal bone, capsule laxity, ligamentous laxity, or muscle hyperactivity are predisposing factors for dislocation [8].…”