Surgical management of recurrent TMJ dislocation—a systematic review

Tocaciu, Shreya; McCullough, Michael; Dimitroulis, George

doi:10.1007/s10006-019-00746-5

Cited by 27 publications

(17 citation statements)

References 43 publications

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“…Treating recurrent TMJ dislocation with a BoNT was described above, and it was generally conducted using electromyographic monitoring for a precise injection into the muscle belly. Injecting BoNT A into the bilateral lateral pterygoid muscle indicated that the TMJ's recurrent dislocation may be avoided for up to six months [55].…”

Section: Discussionmentioning

confidence: 99%

Use of Botulinum Toxin in Orofacial Clinical Practice

Serrera-Figallo

Ruiz-de-León-Hernández

Torrés-Lagares

et al. 2020

Toxins

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Introduction: Botulinum neurotoxin (BoNT) is a potent biological toxin and powerful therapeutic tool for a growing number of clinical orofacial applications. BoNT relaxes striated muscle by inhibiting acetylcholine’s release from presynaptic nerve terminals, blocking the neuromuscular junction. It also has an antinociceptive effect on sensory nerve endings, where BoNT and acetylcholine are transported axonally to the central nervous system. In dentistry, controlled clinical trials have demonstrated BoNT’s efficiency in pathologies such as bruxism, facial paralysis, temporomandibular joint (TMJ) disorders, neuropathic pain, sialorrhea, dystonia and more. Aim: This study’s aim was to conduct a systematic literature review to assess the most recent high-level clinical evidence for BoNT’s efficacy and for various protocols (the toxin used, dilution, dosage and infiltration sites) used in several orofacial pathologies. Materials and methods: We systematically searched the MedLine database for research papers published from 2014 to 2019 with randomly allocated studies on humans. The search included the following pathologies: bruxism, dislocation of the TMJ, orofacial dystonia, myofascial pain, salivary gland disease, orofacial spasm, facial paralysis, sialorrhea, Frey syndrome and trigeminal neuralgia. Results: We found 228 articles, of which only 20 met the inclusion criteria: bruxism (four articles), orofacial dystonia (two articles), myofascial pain (one article), salivary gland disease (one article), orofacial spasm (two articles), facial paralysis (three articles), sialorrhea (four articles) or trigeminal neuralgia (three articles). Discussion: The clinical trials assessed showed variations in the dosage, application sites and musculature treated. Thus, applying BoNT can reduce symptoms related to motor muscular activity in the studied pathologies efficiently enough to satisfy patients. We did not identify the onset of any important side effects in the literature reviewed. We conclude that treatment with BoNT seems a safe and effective treatment for the reviewed pathologies.

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Section: Discussionmentioning

confidence: 99%

Use of Botulinum Toxin in Orofacial Clinical Practice

Serrera-Figallo

Ruiz-de-León-Hernández

Torrés-Lagares

et al. 2020

Toxins

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“…Unlike chronic dislocation, the mandibular condyle is located in its normal position between dislocation episodes. 12,13 Recurrent TMJ dislocation treatment modalities can be organized according to the stability factor into ligaments alteration, musculature alteration, and bony anatomy alteration. Nonsurgical/minimally invasive and surgical/invasive therapies have been used.…”

Section: Dislocation Of Temporomandibular Joint (Tmj)mentioning

confidence: 99%

“…Conservative modalities are usually used before invasive modalities, yet surgical modalities are still superior to non surgical modalities due to its higher success rate. 5,12,13 Eminectomy is one of the widely used surgical procedures to manage recurrent dislocation. It is considered as a "rescue procedure" by many surgeons.…”

Section: Dislocation Of Temporomandibular Joint (Tmj)mentioning

confidence: 99%

“…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%

“…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%

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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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Causes and treatment of temporomandibular luxation—a retrospective analysis of 260 patients

et al. 2023

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Objectives We aimed to clarify the etiology, diagnostic process, and treatment of temporomandibular joint (TMJ) luxation, as the standard care is mainly based on case-reports and systematic studies are lacking. The hypotheses were that luxation occurs spontaneously, recurrence manifests particularly among geriatric patients, and surgery is needed infrequently. Patients and materials A retrospective study of TMJ luxation patients (n = 260) from 2007 to 2020 was designed and implemented. The primary outcome was type of TMJ luxation (i.e., recurrent or non-recurrent), and secondary outcomes were the need for and type of surgical intervention. Predictor variables comprised age, sex, presence of neurological condition, and mechanism of luxation. Administered treatment and clinical outcomes were recorded. Results Of luxation, 61.9% was recurrent and 40.0% due to spontaneous cause. Only 1.9% of patients underwent surgical intervention. The presence of neurological condition caused a 1.34-fold risk for recurrence of luxation and general condition a 1.57-fold risk. Conclusions TMJ luxation is often recurrent, bilateral, and spontaneous. Recurrent luxation is associated with geriatric and neurological conditions, and in this group recurrent TMJ luxation predicted death. Clinical relevance Our findings contribute to more effective diagnostics and treatment of TMJ luxation patients. We show that there is a need to standardize diagnostic measures and treatment patterns. Moreover, collaboration with other specialities, especially neurology and geriatrics, is important.

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Surgical management of recurrent TMJ dislocation—a systematic review

Cited by 27 publications

References 43 publications

Use of Botulinum Toxin in Orofacial Clinical Practice

Use of Botulinum Toxin in Orofacial Clinical Practice

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

Causes and treatment of temporomandibular luxation—a retrospective analysis of 260 patients

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