https://doi.org/10.4081/ecj.2023.11643
Unraveling the intricacies of acute temporomandibular joint dislocation in emergency department: a multidimensional exploration of reduction techniques and success rate by emergency physicians
Submitted: 6 August 2023
Accepted: 4 October 2023
Published: 10 October 2023
Accepted: 4 October 2023
Abstract Views: 588
PDF: 182
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Temporomandibular joint (TMJ) dislocation is a distressing condition that requires prompt management in the emergency setting. This retrospective study aimed to assess the success rate of TMJ reduction performed by emergency physicians (EPs) and evaluate the commonly used reduction techniques and sedative choices. The EPs achieved an overall success rate of 86.29% in reducing the dislocations. Among the successful reductions, 68.21% were accomplished in the first attempt, with only 7.29% requiring three or more attempts. Procedural sedation and analgesia were commonly employed, with midazolam (34.44%) and fentanyl (21.85%) being the most frequently used in successful cases. The Classic intraoral technique (29.14%) was the preferred method for successful reductions. No significant differences were observed in drug utilization or reduction techniques between the groups of successful and failed reductions. The findings demonstrate the high competence of EPs in managing acute TMJ dislocations in the emergency department. The study provides valuable insights into the commonly employed reduction techniques and sedative choices, offering important guidance for emergency medical practice.
Bonanthaya K, Panneerselvam E, Manuel S, Kumar VV. Temporomandibular Joint Dislocation. In: Oral and maxillofacial surgery for the clinician. 1st ed. Singapore: Springer Singapore; 2021. p. 1381–99.
DOI: https://doi.org/10.1007/978-981-15-1346-6
Prechel U, Ottl P, Ahlers OM, Neff A. The Treatment of Temporomandibular Joint Dislocation. Dtsch Arztebl Int 2018;115:59-64.
DOI: https://doi.org/10.3238/arztebl.2018.0059
Chhabra S, Chhabra N, Gupta P Jr. Recurrent Mandibular Dislocation in Geriatric Patients: Treatment and Prevention by a Simple and Non-invasive Technique. J Maxillofac Oral Surg 2015;14:231-4.
DOI: https://doi.org/10.1007/s12663-012-0454-7
Marqués-Mateo M, Puche-Torres M, Iglesias-Gimilio ME. Temporomandibular chronic dislocation: The long-standing condition. Med Oral Patol Oral Cir Bucal 2016;21:776-83.
DOI: https://doi.org/10.4317/medoral.21221
Sang LK, Mulupi E, Akama MK, Muriithi JM. Temporomandibular joint dislocation in Nairobi. East Afr Med J 2010;87:32-7.
DOI: https://doi.org/10.4314/eamj.v87i1.59949
Shorey CW, Campbell JH. Dislocation of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:662-8.
DOI: https://doi.org/10.1067/moe.2000.106693
Liddell A, Perez DE. Temporomandibular joint dislocation. Oral Maxillofac Surg Clin North Am 2015;27:125-36.
DOI: https://doi.org/10.1016/j.coms.2014.09.009
McGoldrick DM, Stassen LF. Management of acute dislocation of the temporomandibular joint in dental practice. J Ir Dent Assoc 2010;56:268-70.
de Souza AAB, de Jesus AO, Soares Araujo SC, et al. Profile of patients with TMJ dislocation in a level-1 emergency hospital: A cross-sectional study. Cranio 2022;18:1-6.
DOI: https://doi.org/10.1080/08869634.2022.2110190
Valesan LF, Da-Cas CD, Réus JC. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig 2021;25:441-453.
DOI: https://doi.org/10.1007/s00784-020-03710-w
Ardehali MM, Tari N, Bastaninejad SH, Amirizad E. Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial. Int J Oral Maxillofac Surg 2016;45:1009-14.
DOI: https://doi.org/10.1016/j.ijom.2016.04.015
Ardehali MM, Kouhi A, Meighani A, Rad FM. Temporomandibular joint dislocation reduction technique: a new external method vs. the traditional. Ann Plast Surg 2009;63:176-8.
DOI: https://doi.org/10.1097/SAP.0b013e31818937aa
Agbara R, Fomete B, Obiadazie AC. Temporomandibular joint dislocation: experiences from Zaria, Nigeria. J Korean Assoc Oral Maxillofac Surg 2014;40:111-6.
DOI: https://doi.org/10.5125/jkaoms.2014.40.3.111
Gorchynski J, Karabidian E, Sanchez M. The syringe technique: A hands-free approach for the reduction of acute nontraumatic temporomandibular dislocations in the emergency department. J Emerg Med 2014;47:676–81.
DOI: https://doi.org/10.1016/j.jemermed.2014.06.050
Papoutsis G, Papoutsi S, Klukowska-Rötzler J, et al. Temporomandibular joint dislocation: a retrospective study from a Swiss urban emergency department. Open Access Emerg Med 2018;10:171-6.
DOI: https://doi.org/10.2147/OAEM.S174116
Martins WD, RibasMde O, Bisinelli J, et al. Recurrent dislocation of the temporomandibular joint: a literature review and two case reports treated with eminectomy. Cranio 2014;32:110-7.
DOI: https://doi.org/10.1179/0886963413Z.00000000017
Young AL, Khan J, Thomas DC, Quek SY. Use of masseteric and deep temporal nerve blocks for reduction of mandibular dislocation. Anesth Prog 2009;56:9-13.
DOI: https://doi.org/10.2344/0003-3006-56.1.9
Neff A, Hell B, Kolk A, et al. S3 LeitlinieKiefergelenkluxation. AWMF Registernummer 2016:007-63.
Neff A, McLeod N, Spijkervet F, et al. The ESTMJS (European Society of Temporomandibular Joint Surgeons) Consensus and Evidence-Based Recommendations on Management of Condylar Dislocation. J Clin Med 2021;10:5068-76.
DOI: https://doi.org/10.3390/jcm10215068
Liu M, Liu M, Lv K. Clinical Trial of Manual Reduction of Temporomandibular Joint Dislocation After Inhalation of Nitrous Oxide. J Craniofac Surg 2019;30:2549-2550.
DOI: https://doi.org/10.1097/SCS.0000000000005816
Xu J, Dong S, Zhou H, et al. The Supine Position Technique Method Is Better Than the Conventional Method for Manual Reduction of Acute Nontraumatic Temporomandibular Joint Dislocation. J Craniofac Surg 2016;27:919-22.
DOI: https://doi.org/10.1097/SCS.0000000000002645
Chan TC, Harrigan RA, Ufberg J, Vilke GM. Mandibular reduction. J Emerg Med 2008;34:435-40.
DOI: https://doi.org/10.1016/j.jemermed.2007.06.037
Chen YC, Chen CT, Lin CH, Chen YR. A safe and effective way for reduction of temporomandibular joint dislocation Ann Plast Surg 2007;58:105-8.
DOI: https://doi.org/10.1097/01.sap.0000232981.40497.32
Adeyemi M, Ernest M, Ibikunle A. Temporomandibular joint dislocation: A 7-year retrospective study in two Nigerian teaching hospitals. Nigerian J Basic Clinical Sci 2022;19:96-100.
DOI: https://doi.org/10.4103/njbcs.njbcs_15_22
Luke N, Munshi K. Women as agents of change: Female income and mobility in India. J Dev Econ 2011;94:1-17.
DOI: https://doi.org/10.1016/j.jdeveco.2010.01.002
Jeyaraj P, Chakranarayan A. A Conservative Surgical Approach in the Management of Longstanding Chronic Protracted Temporomandibular Joint Dislocation: A Case Report and Review of Literature. J Maxillofac Oral Surg 2016;15:361-70.
DOI: https://doi.org/10.1007/s12663-016-0900-z
Ugboko VI, Oginni FO, Ajike SO, et al. A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases. Int J Oral Maxillofac Surg 2005;34:499-502.
DOI: https://doi.org/10.1016/j.ijom.2004.10.025
Moshy JR, Shaban SD. A novel technique for surgical reduction of long-standing temporomandibular joint dislocation. Int J Head Neck Surg 2017;8:107–11.
DOI: https://doi.org/10.5005/jp-journals-10001-1316
Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med 2011;7:10.
DOI: https://doi.org/10.1186/1746-160X-7-10
Edited by
NilSupporting Agencies
NilHow to Cite
Vijay Kumar, S. S., Shekhli, S., & Jose, A. (2023). Unraveling the intricacies of acute temporomandibular joint dislocation in emergency department: a multidimensional exploration of reduction techniques and success rate by emergency physicians. Emergency Care Journal, 19(4). https://doi.org/10.4081/ecj.2023.11643
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
