Treatment of temporomandibular joint luxation: a systematic literature review

Abstract

Objectives To evaluate the effectiveness of surgical and nonsurgical treatment of temporomandibular joint (TMJ) luxation. Materials and methods This systematic literature review searched PubMed, the Cochrane Library, and Web of Science databases to identify randomized controlled trials on TMJ luxation treatment published between the inception of each database and 26 March 2018. Results Two authors assessed 113 unique abstracts according to the inclusion criteria and read nine articles in full text. Eight articles comprising 338 patients met the inclusion criteria, but none of these evaluated surgical techniques. Three studies including 185 patients concerned acute treatment with manual reduction of luxation while five studies including 153 patients evaluated minimally invasive methods with injection of autologous blood or dextrose prolotherapy for recurrent TMJ luxation. These studies reported that mouth opening after treatment was reduced and that independent of type of injection, recurrences of TMJ luxation were rare in most patients. Conclusions In the absence of randomized studies on surgical techniques, autologous blood injection in the superior joint space and pericapsular tissues with intermaxillary fixation seems to be the treatment for recurrent TMJ luxation that at present has the best scientific support. Well-designed studies on surgical techniques with sufficient numbers of patients, long-term follow-ups, and patient experience assessment are needed for selection of the optimal surgical treatment methods. Clinical relevance Autologous blood injection combined with intermaxillary fixation can be recommended for patients with recurrence of TMJ luxation.

The ESTMJS (European Society of Temporomandibular Joint Surgeons) Consensus and Evidence-Based Recommendations on Management of Condylar Dislocation

“…Non-surgical methods should have failed before any minimally invasive or open surgical intervention is considered in acute dislocation [4,10]. Minimally invasive techniques for recurrent dislocation include Botulinum toxin injection [34][35][36][37], sclerotherapy [24,38,39], and autologous blood injection (ABI) [40][41][42][43][44][45][46][47]. The best evidence thus far is for the use of ABI with level of evidence Ib [40].…”

Advanced materials and technologies for oral diseases

“…Injury to the joint disc can lead to symptoms such as joint popping and difficulty opening the mouth. Disorders of the joint disc often require surgical treatment, but surgery in the TMJ area is often complex and can result in complications [ 281 ]. It has been shown that fibrochondrocytes can be used as seed cells to promote the repair of articular discs.…”

Luxación mandibular aguda: técnicas de reducción manual y secuencia de manejo en el Servicio de Urgencia

“…Se estima que la luxación mandibular corresponde al 3 % de las luxaciones articulares del cuerpo 6 . En un servicio de urgencia con aproximadamente 100,000 visitas anuales, se presentaron 37 casos de luxación mandibular durante un periodo de 7 años 7 .…”