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Mandibular (jaw) dislocation

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Mandibular (jaw) dislocation

Mandibular (jaw) dislocation represent about 2.5% of all dislocations and are one- and two-sided. Bilateral dislocations of the lower jaw are more common.

Mandibular (jaw) dislocation occur from excessive opening of the mouth when yawning, vomiting, tooth extraction, the introduction of a gastric tube, at least - with a sharp downward impact on the chin. Interarticular cartilage (meniscus) divides the cavity of the temporomandibular joint (the joint of the lower jaw) into two halves - the top and bottom.

During normal opening mouth articulated head of the lower jaw move forward only in respect of the meniscus. At a stronger jaw open mouth head slides anteriorly on the articular fossa already together with the meniscus while predsustavny bump (tuberculum articulare) will not stop this movement.

Predisposing cause of dislocation is flattening or lack of development predsustavnogo tubercle, which is often seen in women. For this reason, and dislocation of their notes more often than men.

The mechanism of the origin of dislocation with fast, wide-open mouth is that one or both of the lower jaw joint head rolled on predsustavny mound. Going from the styloid process (processus styloideus) along the length of the vertical branches to the corner of the lower jaw powerful subulately-mandibular ligament (lig. Stylo-mandibulare) behind, as well as sphenomandibular ligament (lig. Spheno-mandibulare) inwards while tense. Mandibular angle, held them both reins and pulls backwards and upwards, becoming a place for the whole jaw locking for the lever and shifts Condyles more anterior to the articular tubercle. In this position the head with uschemlёnnymi menisci, ligaments in addition to the voltage specified, fixed voltage masticatory muscles. One gets the inability jaw heads jump back through the articular tubercle.

Location of the temporomandibular joint (TMJ) on the skull.

Mandible bilateral dislocation symptoms

Mandible bilateral dislocation symptoms:

  • mouth open, chin jutting forward and springy
  • occlusion of the teeth is not possible
  • saliva is secreted
  • speech is difficult
  • cheeks are flattened
  • anterior to the tragus - deep pit
  • articular head of the lower jaw detectable under the zygomatic arch, and underneath the rollers protrude chewing muscles

At unilateral dislocation of the lower jaw these symptoms - only on one side. Jaw less fixed. Chin rejected in a healthy way. The latter fact is important, since the turn of the articular processes chin is deviated towards the fracture.

Bilateral temporomandibular joint (TMJ) dislocation on X-ray.
Bilateral temporomandibular joint (TMJ) dislocation on X-ray.

 

Mandibular (jaw) dislocation reduction technique

Reduction of bilateral dislocation of the mandible manage easily and without anesthesia. The principle of it is to be stuck in front of the tubercle predsustavnogo head hold back over the ledge tubercle. For this purpose, the patient sits on a low seat with a support under the back of his head. In both series the lower teeth surgeon puts his thumbs, possibly reaching up to the end of their corners, and the other fingers grip the lower jaw from the outside. Making the angle of the lower jaw pivot point, the surgeon quickly makes finger pressure on the corner down and back; while doing chin upwards and backwards movement.

The procedure for reduction of dislocation of the lower jaw is carried out in a vertical position with the patient's finger protection physician.

If you can not immediately reposition both sides, it is necessary to try to straighten first one way, then another. Otherwise, easy to manage reduction under general anesthesia. Dressing capistrum and liquid food for 2-3 weeks, in order to avoid a repetition of the dislocation of the mandible.

There are cases of chronic dislocations reposition of the lower jaw in 8 months. If irreducible dislocation of the lower jaw, preventing the act of chewing, showing rapid reduction or resection of the articular ends. If you have a habitual dislocation of the lower jaw with the aim of sclerotherapy injection is recommended in the temporomandibular joint or in the circle of his solution of iodine or alcohol, and in any case it is necessary to limit the wide opening of the mouth.

Mandibular (jaw) dislocation posteriorly - is extremely rare. It turns out in direct effort - impact front chin when the mouth is closed. Condyles at the posterior dislocation of of the lower jaw, dramatic shift posteriorly can to break through the auditory canal.