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1、TEMPOROMANDIBULARDISLOCATIONBYDR.MANISHAMISHRATMJThetemporomandibularjoint(TMJ)isthearticulationofthetemporalandmandibularbonesTMJdislocationoccurswhenthecondyletravelsanteriorlyalongthearticulareminenceandbecomeslockedintheanteriorsuperioraspectoftheeminence,preventingclo
2、sureofthemouth.Thisresultsinstretchingoftheligaments,andisassociatedwithseverespasmofthemusclesthatopenandclosethemouth(ie,themasseter,internalpterygoid,andtemporalis).TheresultanttrismuspreventsthecondylefromreturningtothemandibularfossaCauses:DeepyawningProlongDentalproc
3、eduresAirwaymanipulationparticularlyinananaesthetisedpatient.Dislocationcanoccurduringlaryngoscopy,transoralfiberopticbronchoscopyandintubation.Clinicalfeatures:TMJdislocationmayoccurwithtrauma,butmostoftenfollowsextremeopeningofthemouthduringyawning,laughing,singing,vomit
4、ing,ordentaltreatment.Dislocationalsocanresultfromdystonicreactionstodrugs.Symmetricmandibulardislocationismostcommon,butunilateraldislocationwiththejawdeviatingtotheoppositesidealsocanoccur.TMJdislocationispainfulandfrighteningforthepatient.Onexamination:Thepatientisunabl
5、etoclosethemouthandthereisexcessivesalivation.Adepressionmaybenotedinthepreauriculararea.PalpationoftheTMJrevealsoneorbothofthecondylestrappedinfrontofthearticulareminenceandspasmofthemusclesofmastication.Patientspronetomandibulardislocationincludethosewithananatomicmismat
6、chbetweenthefossaeandarticulareminence,weaknessofthecapsuleandthetemporomandibularligaments,andtornligaments.Patientswhohavehadoneepisodeofdislocationarepredisposedtorecurrence.Diagnosis:Thedentistbasesthediagnosisonthepositionofthejawandtheperson'sinabilitytoclosehisorher
7、mouth.RadiographsoftheTMJarenotalwaysnecessary,butshouldbeobtainedtoexcludecondylarfractureifthedislocationisrelatedtotraumaTheproblemremainsuntilthejointismovedbackintoplace.However,theareacanbetenderforafewdays.Treatment:Themusclessurroundingthetemporomandibularjointneed
8、torelaxsothatthecondylecanreturntoitsnormalposition.Manypeoplecanhavetheirdislocatedjawco
