Recurrent dislocation of the temporomandibular joint: a literature review and two case reports treated with eminectomy

Martins, Wilson; Ribas, Marina de Oliveira; Bisinelli, Julio César; França, Beatriz Helena Sottile; Martins, Guilherme Bottino

doi:10.1179/0886963413z.00000000017

Cited by 24 publications

(13 citation statements)

References 40 publications

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“…Thus, they concluded that, based on the data available at the time of their review, it was not possible to determine the treatment option that could guarantee a longterm elimination of recurrent TMJ luxation [15]. Another nonsystematic review combined with case reports concluded that accurate comparisons of the reported surgical interventions are difficult because of varying follow-up times and definitions of success [8].…”

Section: Discussionmentioning

confidence: 99%

“…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]. Bilateral luxation of the TMJ is most common with the mandible in a straight open position [8], whereas with a single-sided luxation, the mandible is deviated to the opposite side, with a partially open mouth. Luxation of the TMJ represents 3% of all cases of reported dislocated joints in the body [9].…”

Section: Incidencementioning

confidence: 99%

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Treatment of temporomandibular joint luxation: a systematic literature review

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

Treatment of temporomandibular joint luxation: a systematic literature review

et al. 2019

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“…Since then, eminectomy has been successfully used alone or with other procedure for treatment of recurrent TMJ dislocation. 10,12,13,[16][17][18][19] Partial eminectomy (reduction eminoplasty) has been introduced as a modification of complete eminectomy. In this procedure, the eminence is partially reduced instead of complete removal.…”

Section: Dislocation Of Temporomandibular Joint (Tmj)mentioning

confidence: 99%

“…Eminoplasty lowers the risk of perforation into the middle cranial fossa compared to eminectomy, moreover it represent a reliable alternative in case of eminence pneumatization. 16,[20][21][22][23] Recent systematic reviews showed that despite the presence of numerous studies evaluating surgical management for recurrent TMJ dislocation, they are limited to case series and reports with low scientific evidence, and recommended well designed trials on this topic. 13,24 The aim of this study was to compare recurrence, operation time, and TMJ pain following eminectomy versus eminoplasty in patients with recurrent TMJ dislocation.…”

Section: Dislocation Of Temporomandibular Joint (Tmj)mentioning

confidence: 99%

Eminectomy versus eminoplasty for treatment of recurrent temporomandibular dislocation: Randomized controlled clinical trial

Gengehy

Ali

Ashraf

2019

Egyptian Dental Journal

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Purpose: The aim of this study was to compare recurrence, operation time, and temporomandibular joint (TMJ) pain following eminectomy versus eminoplasty in patients with recurrent TMJ dislocation. Materials and methods: 12 patients with bilateral TMJ recurrent dislocation were included in this study. Bilateral eminectomy was performed for 6 patients, and bilateral reduction eminoplasty was performed for the other 6 patients. Recurrence rate, operation time, TMJ pain, TMJ noise, postoperative complications were assessed and compared between the 2 groups. Results: No recurrence was observed in the eminectomy group. While in the eminoplasty group, recurrent dislocation occurred in 33.3% of the patients. Operation time was shorter in the eminoplasty group compared to the eminectomy group (40.75 ± 5.17, 47.3 ±7.27 minutes. TMJ pain at different time points, and TMJ noise were was comparable in the 2 groups. Conclusions: Eminectomy is superior to eminoplasty for treatment of recurrent TMJ dislocation. Eminoplasty can represent an alternative for eminectomy in cases with risk of intracranial perforation, subjected for further investigations.

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“…Causative factors for TMJ dislocation include: trauma, excessive mouth opening during yawning, laughing, vomiting, or lengthy dental procedures. Laxity in articular ligaments or the capsule, syndromes such as Marfan's syndrome and Ehlers-Danlos syndrome that cause connective tissue and joint laxity, as well as altered anatomical or dysfunctional components of the TMJ, have also been identified as factors of TMJ dislocation [2]. TMJ dislocation can be classified as acute, chronic recurrent or chronic protracted dislocation [3].…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Chronic and Refractory TMJ Dislocation in Medically Compromised Patients

Elgazzar¹,

Ward²

2018

Dentistry

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Recurrent and long-standing chronic dislocations of the Temporomandibular Joint (TMJ) are relatively rare conditions that have a profoundly negative impact on a patient's quality of life. To date, no definitive protocols or guidelines exist regarding the appropriate management of these conditions. Many diverse methods have been employed ranging from non-surgical conservative approaches to invasive surgical procedures to correct recurrent and chronic long-standing dislocations. In this article, two different cases are presented; case #1 a chronic recurrent TMJ dislocation in association with Ehlers-Danlos syndrome; and case #2, a chronic protracted TMJ dislocation in the setting of myotonic dystrophy. These two cases were successfully treated using two different treatment modalities after conservative management had failed. In case #1, a combination of bilateral eminence augmentation utilizing L-shaped reconstruction plates, TMJ capsular augmentation with a temporalis myofascial flap as well as lateral pterygoid myotomy was employed. In case #2, a condylectomy was used to resolve the long-standing dislocation. Both patients have not demonstrated any functional limitations or recurrence 2 years after surgical intervention. From these observations, we support utilizing these two techniques in the surgical management of chronic and refractory dislocation respectively.

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Recurrent dislocation of the temporomandibular joint: a literature review and two case reports treated with eminectomy

Abstract: Eminectomy results in long-term resolution of recurrent TMJ dislocations, when compared with others surgical techniques.

Cited by 24 publications

References 40 publications

Treatment of temporomandibular joint luxation: a systematic literature review

Treatment of temporomandibular joint luxation: a systematic literature review

Eminectomy versus eminoplasty for treatment of recurrent temporomandibular dislocation: Randomized controlled clinical trial

Surgical Management of Chronic and Refractory TMJ Dislocation in Medically Compromised Patients

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