Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
Laboratory Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
BMC Oral Health. 2024 Sep 27;24(1):1127. doi: 10.1186/s12903-024-04925-z.
Temporomandibular joint dislocation is a common challenge in dental care, but it can be promptly addressed through manual realignment, making it standard procedure in the realm of oral health. Nonetheless, effectively preventing and treating chronic protracted mandibular dislocation (CPMD), characterized by prolonged dislocation, remains a significant challenge. Hence, a retrospective analysis was conducted on the clinical data of 10 patients diagnosed with chronic protracted mandibular dislocation (CPMD), encompassing diagnosis, treatment, and prognosis details. CPMD tends to be more prevalent among the elderly population, with an average age of 67.2±11.9 years and a male-to-female ratio of 1:9. All diagnosed patients presented with bilateral anterior dislocation, each requiring diverse pre-treatment approaches. The most significant risk factor contributing to CPMD was unconsciousness resulting from nervous system injury, which delayed the perception of symptoms associated with temporomandibular joint dislocation. 90% of CPMD patients experienced successful treatment through manual reduction, while a refractory CPMD cohort, resistant to manual reduction, necessitated surgical intervention for resolution. All patients underwent treatment involving elastic intermaxillary traction, which served as the primary means of achieving reduction. Subsequent analysis of CT data revealed that condylar displacement beyond the zygomatic arch served as an indication for surgical reduction. Consequently, manual reduction under general anesthesia combined with elastic intermaxillary traction proved effective for managing CPMD cases. However, cases displaying excessive vertical displacement beyond the zygomatic arch should be considered for surgical intervention based on CT findings.
颞下颌关节脱位是口腔护理中常见的问题，但通过手动复位可以迅速解决，这在口腔健康领域已成为标准程序。然而，有效预防和治疗慢性迁延性下颌脱位（CPMD），即长时间脱位，仍然是一个重大挑战。因此，对 10 例慢性迁延性下颌脱位（CPMD）患者的临床资料进行了回顾性分析，包括诊断、治疗和预后的详细情况。CPMD 多见于老年人群，平均年龄为 67.2±11.9 岁，男女比例为 1:9。所有确诊患者均表现为双侧前脱位，每个患者都需要不同的治疗前方法。导致 CPMD 的最大危险因素是神经系统损伤导致的无意识，这延迟了对颞下颌关节脱位相关症状的感知。90%的 CPMD 患者通过手动复位成功治疗，而对常规治疗有抵抗的难治性 CPMD 患者则需要手术干预。所有患者均接受了弹性颌间牵引治疗，这是实现复位的主要手段。随后对 CT 数据的分析显示，髁突移位超过颧骨弓是手术复位的指征。因此，全麻下手动复位结合弹性颌间牵引对 CPMD 病例有效。然而，根据 CT 检查结果，对于显示出超出颧骨弓的过度垂直移位的病例，应考虑手术干预。
