Management of chronic recurrent temporomandibular joint dislocations: a retrospective study.
OBJECTIVE
The purpose of this study is to evaluate the clinical results of patients who received surgical treatment for chronic recurrent dislocations (CRD). In our clinical practice CRD patients were classified into 5 types depending upon their aetiology. These patients were treated by two different surgical techniques, eminectomy or augmentation of the eminence by autograft depending on their classification.


METHODS
Nineteen patients with CRD attended the clinic for surgical treatment. Patients were classified accordingly into 5 types of CRD. Eminoplasty was used in the treatment of twelve patients with type I and II disease. An oblique osteotomy of the eminence was carried out. Harvested chin graft was contoured to a wedge form and inserted tightly into the osteotomy site. The augmentation of the eminence was provided by an inlay cortical bone graft without using any of the conventional fixation materials. The remaining 7 patients with type III, IV and V disease were treated by eminectomy. The factors evaluated were pre- and post-operative maximal incisor opening, sex, age, number and type of previous operations, cause and type of the CRD, and the previous treatment of the patients.


RESULTS
The survey is based on nineteen patients who were treated in the same department. Patients age ranged from 22 to 80 years. Females are dominated in the study. The follow-up period ranged from 1 to 12 years. Free excursions of the condyles were achieved in the patients treated by two different techniques. On the other hand, maximum interincisal openings were higher in the patients treated by eminectomy when compared with the patients who had eminoplasty.


CONCLUSIONS
So far as the quality of life for the patients with CRD is concerned, the most appropriate technique (whether it be to confine the condyle or allow its free movement) to be employed should be decided by following an comprehensive evaluation of the patients' history.
Güven
Orhan
O
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey. oguven@dentistry.ankara.edu.tr
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000209:etiology / Q000601:surgery*; D008297:Male; D008335:Mandibular Condyle / Q000503:physiopathology; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013701:Temporal Bone / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000145:classification / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult