Conservative Reduction by Lever Action of Chronic Bilateral Mandibular Condyle Dislocation

Aims: The treatment of long-standing dislocation of the temporomandibular joint is broadly classified into open reduction and closed reduction. The current study presents a case of long-standing dislocation of the temporomandibular joint treated three years after dislocation.  In this study, the authors evaluated the long-term outcome of conservative reduction by lever action of chronic bilateral mandibular condyle dislocation.

Methodology: Manual repositioning of temporomandibular joint dislocation lasting for three years in a 31-year-old woman was attempted without success; therefore, conservative reduction by lever action was carried out because the patient declined treatment under general anesthesia.

Results: The treatment was discontinued after six days because of the subluxation of the retaining tooth. The retainer was changed from tooth to screw for intermaxillary fixation, and treatment was reinstituted. Fifteen days later, reduction was achieved and retention was started and continued for two months. The outcome was good, with no recurrent dislocation within 24 months of the treatment.

Conclusions: Conservative reduction by lever action, involving minimally invasive treatment and little dysfunction, should be considered an optional conservative treatment.

References

1. Muller, GM. Long-standing dislocation of mandible. Brit, M. J., 1 :572, 1946.

2. Fordyce, GL. Long-standing bilateral dislocation of the jaw. Brit. J. Oral Surg., 2:222, 1965.