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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Conservative Surgical Approach in the Management of Longstanding Chronic Protracted Temporomandibular Joint Dislocation: A Case Report and Review of Literature</title><author><name sortKey="Jeyaraj, Priya" sort="Jeyaraj, Priya" uniqKey="Jeyaraj P" first="Priya" last="Jeyaraj">Priya Jeyaraj</name><affiliation><nlm:aff id="Aff1">Command Military Dental Centre, Udhampur, Jammu & Kashmir 182101 India</nlm:aff></affiliation></author><author><name sortKey="Chakranarayan, Ashish" sort="Chakranarayan, Ashish" uniqKey="Chakranarayan A" first="Ashish" last="Chakranarayan">Ashish Chakranarayan</name><affiliation><nlm:aff id="Aff2">Military Dental Centre, Jabalpur, Madhya Pradesh 482001 India</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27408471</idno><idno type="pmc">4925610</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925610</idno><idno type="RBID">PMC:4925610</idno><idno type="doi">10.1007/s12663-016-0900-z</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000948</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000948</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Conservative Surgical Approach in the Management of Longstanding Chronic Protracted Temporomandibular Joint Dislocation: A Case Report and Review of Literature</title><author><name sortKey="Jeyaraj, Priya" sort="Jeyaraj, Priya" uniqKey="Jeyaraj P" first="Priya" last="Jeyaraj">Priya Jeyaraj</name><affiliation><nlm:aff id="Aff1">Command Military Dental Centre, Udhampur, Jammu & Kashmir 182101 India</nlm:aff></affiliation></author><author><name sortKey="Chakranarayan, Ashish" sort="Chakranarayan, Ashish" uniqKey="Chakranarayan A" first="Ashish" last="Chakranarayan">Ashish Chakranarayan</name><affiliation><nlm:aff id="Aff2">Military Dental Centre, Jabalpur, Madhya Pradesh 482001 India</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Maxillofacial & Oral Surgery</title><idno type="ISSN">0972-8279</idno><idno type="eISSN">0974-942X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Chronic protracted dislocation of the TMJ is a relatively uncommon but extremely unpleasant and distressing condition for a patient. It is also particularly challenging and difficult to treat as it worsens with time due to continuing spasm of the masticatory muscles and progressive fibrosis, adhesions and consolidation in and around the dislocated joint. No definite guidelines or treatment protocols have been laid down in literature till date, towards management of such dislocations. A range of extensive and invasive surgical procedures such as eminectomy, condylectomy, menisectomy, and various osteotomies of the mandibular ramus and body have been performed to reduce these dislocations. A chronic longstanding unilateral TMJ dislocation in a 64-year-old woman was managed successfully and effectively using a modified, rather conservative surgical technique. The aim was to reduce the dislocated condyle (without excessive manipulation of the intra-articular space or extra-articular joint components); and at the same time, to limit further excessive translation of the condyle and restore physiological TMJ biomechanical constraints, to prevent future recurrence. This was achieved by surgically exposing the dislocated joint and manipulating the anterosuperiorly positioned condyle back into the glenoid fossa, aided by a downward distraction of the mandible; followed by soft tissue tethering of the meniscus and fibrous capsule of the joint to the temporal fascia above. The procedure yielded excellent results without any functional limitations or recurrence, and can hence constitute a viable and effective treatment option which can be attempted prior to resorting to the more invasive surgical procedures as described in literature.</p></div></front></TEI><pmc article-type="case-report"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Maxillofac Oral Surg</journal-id><journal-id journal-id-type="iso-abbrev">J Maxillofac Oral Surg</journal-id><journal-title-group><journal-title>Journal of Maxillofacial & Oral Surgery</journal-title></journal-title-group><issn pub-type="ppub">0972-8279</issn><issn pub-type="epub">0974-942X</issn><publisher><publisher-name>Springer India</publisher-name><publisher-loc>New Delhi</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27408471</article-id><article-id pub-id-type="pmc">4925610</article-id><article-id pub-id-type="publisher-id">900</article-id><article-id pub-id-type="doi">10.1007/s12663-016-0900-z</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>A Conservative Surgical Approach in the Management of Longstanding Chronic Protracted Temporomandibular Joint Dislocation: A Case Report and Review of Literature</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Jeyaraj</surname><given-names>Priya</given-names></name><address><email>jeyarajpriya@yahoo.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Chakranarayan</surname><given-names>Ashish</given-names></name><xref ref-type="aff" rid="Aff2"></xref></contrib><aff id="Aff1"><label></label>Command Military Dental Centre, Udhampur, Jammu & Kashmir 182101 India</aff><aff id="Aff2"><label></label>Military Dental Centre, Jabalpur, Madhya Pradesh 482001 India</aff></contrib-group><pub-date pub-type="epub"><day>21</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2016</year></pub-date><volume>15</volume><issue>Suppl 2</issue><fpage>361</fpage><lpage>370</lpage><history><date date-type="received"><day>15</day><month>6</month><year>2015</year></date><date date-type="accepted"><day>21</day><month>3</month><year>2016</year></date></history><permissions><copyright-statement>© The Association of Oral and Maxillofacial Surgeons of India 2016</copyright-statement></permissions><abstract id="Abs1"><p>Chronic protracted dislocation of the TMJ is a relatively uncommon but extremely unpleasant and distressing condition for a patient. It is also particularly challenging and difficult to treat as it worsens with time due to continuing spasm of the masticatory muscles and progressive fibrosis, adhesions and consolidation in and around the dislocated joint. No definite guidelines or treatment protocols have been laid down in literature till date, towards management of such dislocations. A range of extensive and invasive surgical procedures such as eminectomy, condylectomy, menisectomy, and various osteotomies of the mandibular ramus and body have been performed to reduce these dislocations. A chronic longstanding unilateral TMJ dislocation in a 64-year-old woman was managed successfully and effectively using a modified, rather conservative surgical technique. The aim was to reduce the dislocated condyle (without excessive manipulation of the intra-articular space or extra-articular joint components); and at the same time, to limit further excessive translation of the condyle and restore physiological TMJ biomechanical constraints, to prevent future recurrence. This was achieved by surgically exposing the dislocated joint and manipulating the anterosuperiorly positioned condyle back into the glenoid fossa, aided by a downward distraction of the mandible; followed by soft tissue tethering of the meniscus and fibrous capsule of the joint to the temporal fascia above. The procedure yielded excellent results without any functional limitations or recurrence, and can hence constitute a viable and effective treatment option which can be attempted prior to resorting to the more invasive surgical procedures as described in literature.</p></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Acute TMJ dislocation</kwd><kwd>Chronic protracted/persistent dislocation (CPD)</kwd><kwd>Chronic recurrent dislocation (CRD)</kwd><kwd>Meniscal plication</kwd><kwd>Capsular plication</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Association of Oral and Maxillofacial Surgeons of India 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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