Conservative management of a 3 months long standing bilateral temporomandibular joint dislocation: A case report

Abstract

Temporomandibular joint (TMJ) dislocation is a type of condition where the condyle is anteriorly displaced beyond the articular eminence. Long standing cases with TMJ dislocation condition persisting for more than a month becomes challenging to treat. Its management includes closed reduction to complicated surgical procedures so as to reduce the dislocated condyles. Mandibular dislocation cases present with its own distinctive features. The aim of the report is to reduce the dislocated condyles through conservative management.This paper presents with non-invasive and conservative method for management of a long standing case (three months old) of TMJ dislocation in patient with acute renal failure and uncontrolled diabetes giving excellent outcome using elastic traction. Elastic traction with fulcrum on molars for reduction and inter-maxillary fixation was done in order to stabilize the mandibular condyles into the glenoid fossa. Here we stressed on the effectiveness of continuous traction using elastics and Inter-maxillary fixation (IMF) in achieving a complete repositioning of the mandibular condyles back into the fossaCondyles were reduced back in glenoid fossa with excellent outcome.Where manual reduction is not possible, elastic traction and IMF is the only method to reduce condyles. In long standing chronic TMJ dislocation case, only manual reduction was not sufficient. Since no standard rules for the ideal strategy are available till date, initial approach must be conservative so to preserve surgical treatment for later if needed.