Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Conservative management of dislocated temporomandibular joints: A case report

턱관절 탈구의 보존적 치료법에 대한 증례보고

  • Park, Jo-Eun (Department of Oral Medicine, School of Dentistry, Dankook University) ;
  • Kim, Hye-Kyoung (Department of Oral Medicine, School of Dentistry, Dankook University) ;
  • Choi, Hee-Hoon (Department of Oral Medicine, Department of Dentistry, The Armed Forces Yangju Hospital) ;
  • Kim, Mee-Eun (Department of Oral Medicine, School of Dentistry, Dankook University)
  • 박좋은 (단국대학교 치과대학 구강내과학교실) ;
  • 김혜경 (단국대학교 치과대학 구강내과학교실) ;
  • 최희훈 (국군양주병원 치과부 구강내과) ;
  • 김미은 (단국대학교 치과대학 구강내과학교실)
  • Received : 2013.08.01
  • Accepted : 2013.08.30
  • Published : 2013.12.30
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Abstract

Dislocation of the temporomandibular joint (TMJ) occurs when the mandibular condylar head is displaced completely out of the glenoid fossa and cannot be reduced by the patient. The occurrence of bilateral anterior dislocation is the most common. Dislocations can be classified into three types in terms of duration and frequency of dislocation, i.e., acute, chronic and recurrent. There are various treatment modalities for dislocation from conservative try to surgical intervention. The selection for the appropriate modality mainly depends on the types of dislocation as previously stated. The authors report three cases of dislocation with different treatment modalities according to the duration of dislocation. In particular, we tried prosthetic approach instead of surgical intervention in the patient with chronic dislocation.

턱관절의 탈구는 과두가 관절와를 벗어나 환자 스스로 원래 위치로 정복하지 못할 때 발생한다. 양측성 전방 탈구가 가장 흔하며 탈구의 빈도와 발생 기간에 따라 급성, 만성, 재발성으로 분류하기도 한다. 턱관절 탈구의 치료법으로 수조작 같은 보존적 방법부터 수술적 접근법까지 다양한 방법들이 있으며 치료법의 선택은 주로 탈구가 발생한 기간에 따라 달라진다. 본 증례를 통해서 수조작을 시행하여 턱관절의 탈구를 성공적으로 치료한 증례와 과두의 정복에 실패했으나 만성적으로 적응된 환자에서 수술적 치료 대신 보철 치료로 교합을 회복시켜준 사례를 소개하고 그 의의에 대해 고찰해보고자 한다.

Keywords

References

  1. Chan TC, Harrigan RA, Ufberg J, Vilke GM. Mandibular reduction. J Emerg Med. 2008;34(4):435-440. https://doi.org/10.1016/j.jemermed.2007.06.037
  2. Thompson WR. Dislocation (luxation) of the temporomandibular joint. Oral Health. 1967;57(6):431-434.
  3. Imbery TA, Mirrielees RA. An alternative manual method for reducing temporomandibular luxations. Gen Dent. 1990;38(2):147-148.
  4. Shorey CW, Campbell JH. Dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(6): 662-668. https://doi.org/10.1067/moe.2000.106693
  5. Smally AJ, DelGross C. Spontaneous temporomandibular joint dislocation in an 80-year-old man. J Fam Pract. 1995;40(4): 395-398.
  6. Luyk NH, Larsen PE. The diagnosis and treatment of the dislocated mandible. Am J Emerg Med. 1989;7(3):329-335. https://doi.org/10.1016/0736-4679(89)90293-X
  7. Sanders B, Schneider J, Given J. Prolonged dislocation of the mandibular condyle: report of case. J Oral Surg. 1979;37(5):346-348.
  8. Ozcelik TB, Pektas ZO. Management of chronic unilateral temporomandibular joint dislocation with a mandibular guidance prosthesis: a clinical report. J Prosthet Dent. 2008;99(2):95-100. https://doi.org/10.1016/S0022-3913(08)60024-4
  9. Shakya S, Ongole R, Sumanth KN, Denny CE. Chronic bilateral dislocation of temporomandibular joint. Kathmandu Univ Med J. 2010;8(30):251-256.
  10. Littler BO. The role of local anaesthesia in the reduction of long-standing dislocation of the temporomandibular joint. Br J Oral Surg. 1980;18(1):81-85. https://doi.org/10.1016/0007-117X(80)90056-6
  11. Tobias JD. Applications of nitrous oxide for procedural sedation in the pediatric population. Pediatr Emerg Care. 2013;29(2): 245-265. https://doi.org/10.1097/PEC.0b013e318280d824
  12. Lahoud GY, Averley PA. Comparison of sevoflurane and nitrous oxide mixture with nitrous oxide alone for inhalation conscious sedation in children having dental treatment: a randomised controlled trial. Anaesthesia. 2002;57(5):446-450. https://doi.org/10.1046/j.0003-2409.2002.02569.x
  13. Ziegler CM, Haag C, Mühling J. Treatment of recurrent temporomandibular joint dislocation with intramuscular botulinum toxin injection. Clin Oral Investig. 2003;7(1):52-55.
  14. Adekeye EO, Shamia RI, Cove P. Inverted L-shaped ramus osteotomy for prolonged bilateral dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol. 1976;41(5):568-577. https://doi.org/10.1016/0030-4220(76)90308-X
  15. Benny RA. Prolonged unilateral dislocation of the mandible. J Oral Surg. 1978;36(8):623-624.