Nikunj Anand, Khan Naved, Rajkhokar Dilpreet, Mishra Biswajit, Rajurkar Suday
Department of Oral and Maxillofacial Surgery, Government Dental College, Raipur, IND.
Department of Oral and Maxillofacial Surgery, Nair Hospital Dental College, Mumbai, IND.
Cureus. 2022 Mar 25;14(3):e23478. doi: 10.7759/cureus.23478. eCollection 2022 Mar.
Approximately 15%-30% of patients receiving neuroleptic medication for a longer duration develop drug-induced dystonia. There are many variations of oromandibular dystonia (OMD), but the most common one is involuntary jaw-opening dystonia. A rare case of chronic mandibular dislocation under long-term neuroleptic therapy is reported with clinical features, diagnosis, and various treatment modalities. Chronic dislocation leads to changes in associated soft tissue and muscles. Therefore, besides alteration of bony articular surfaces (eminectomy), soft tissue remodeling is required to achieve the perfect balance for temporomandibular joint (TMJ) working and occlusion. Drug-induced orofacial dystonia presenting as chronic TMJ dislocation is rare. Therefore, in long-standing chronic dislocation cases during treatment, biomechanics of TMJ, its complex neurological system, and the physiology of the masticatory system should be considered to customize the treatment plan.
接受较长时间抗精神病药物治疗的患者中，约15% - 30%会出现药物性肌张力障碍。口下颌肌张力障碍（OMD）有多种变体，但最常见的是不自主张口肌张力障碍。本文报告了1例长期接受抗精神病药物治疗导致慢性下颌脱位的罕见病例，并介绍了其临床特征、诊断及各种治疗方式。慢性脱位会导致相关软组织和肌肉发生变化。因此，除了改变骨关节面（髁突切除术）外，还需要进行软组织重塑，以实现颞下颌关节（TMJ）功能和咬合的完美平衡。表现为慢性TMJ脱位的药物性口面部肌张力障碍较为罕见。因此，在治疗长期慢性脱位病例时，应考虑TMJ的生物力学、其复杂的神经系统以及咀嚼系统的生理学，以制定个性化的治疗方案。
