Baptist Joanna, Baliga Mohan
Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Mangaluru, Karnataka India.
Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal University, Mangaluru, Karnataka India, e-mail:
J Contemp Dent Pract. 2017 Jan 1;18(1):78-79. doi: 10.5005/jp-journals-10024-1994.
Mandibular dislocation occurs when the condylar head glides out of the glenoid fossa with the condyle positioned in such a way that its posterior articulating surface lying ahead of the articular eminence. Recurrent mandibular dislocation is relatively uncommon. Patient is extremely distressed and goes through a lot of discomfort. Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs. Acute dislocations are best managed immediately by reduction and intermaxillary fixation. However, dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible. Such chronic recurrent dislocations are surgically managed with eminectomy, meniscectomy, and condylotomies. A downward and forward osteotomy of the zygomatic arch in front of the articular eminence so as to produce a mechanical obstruction was recommended by Dautrey and Gosserez. This article will highlight the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints (TMJs) bilaterally employing Dautrey's procedure.
当髁突头部滑出关节窝，且髁突处于其后方关节面位于关节结节前方的位置时，就会发生下颌关节脱位。复发性下颌关节脱位相对少见。患者会极度痛苦，经历诸多不适。文献中提到了多种病因，如在牙科手术过程中长时间张大嘴巴、打哈欠、大笑、下颌骨外伤、精神障碍以及某些药物。急性脱位最好立即通过复位和颌间固定进行处理。然而，持续一个月以上的脱位被认为是慢性的，通过手动操作下颌骨无法成功复位。此类慢性复发性脱位通过关节结节切除术、半月板切除术和髁突截骨术进行手术治疗。Dautrey和Gosserez建议在关节结节前方进行颧弓向下向前截骨，以形成机械性阻挡。本文将重点介绍采用Dautrey手术双侧治疗六例颞下颌关节（TMJ）慢性复发性脱位患者的手术经验。
