54. Diseases of the TMJ: Dislocation & subluxation - classification, etiology, clinics, diagnosis, DDx, treatment

Question 1

Condylar dislocation of the TMJ

Answer 1

• Hypermobility condition of the jaw => condyle becomes positioned anterior and superior to the articular eminence during jaw opening or protrusion=>
• Unable to return to a closed position=>
• Inability to close the mouth, difficulty speaking, drooling, and lip incompetency

aka open lock

Question 2

How TMJ dislocation classified

Answer 2

• Partial (subluxation) or complete (luxation) dislocation
• Bilateral or unilateral dislocation
• Acute, chronic protracted, or chronic recurrent dislocation
• Anterior dislocation (most common), medial, lateral, superior (into the middle cranial fossa), and posterior dislocation (rare, usually associated with trauma)

Question 3

Clinical features of TMJ dislocation

Answer 3

• Inability to close the mouth, difficulty speaking, drooling, and lip incompetency
• Pain in the preauricular region=>
• Acute cases
• Deviation of the chin to the contralateral side=> Bilateral or unilateral dislocation

Question 4

Common etiologies of TMJ dislocation

Answer 4

• Trauma and extended periods of mouth opening
• Manifestations of joint hypermobility
• Imbalance in neuromuscular function or structural deficit
• Age and changes in dentition
• Dental treatments=>third molar extractions, root canal treatments

Question 5

Akinbam TMJ dislocation classification

Answer 5

• Type I: The head of the condyle is directly below the tip of the eminence.
• Type II: The head of the condyle is in front of the tip of the eminence.
• Type III: The head of the condyle is high-up in front of the base of the eminence.

Question 6

Treatment options for TMJ dislocation

Answer 6

• Manual Reduction=> reposition the condyle back into the fossa
• Analgesics and muscle relaxants=> relieve pain and muscle spasm
• Physical Therapy=> Jaw exercises to strengthen muscles and prevent recurrence
• Surgery=> severe or recurrent cases