Surgical treatment of chronic temporomandibular joint dislocation: A case report

Introduction: Chronic dislocation of temporomandibular joint is usually treated with conservative approaches, but in some cases, surgery is needed to avoid recurrencies. The present paper described a case report of a bilateral intervention for articular tubercle height augmentation by means of calvaria bone grafts. Materials and Methods: A 32-year-old woman attended the Department of Maxillofacial Surgery, University of Padova, Italy, in January 2007 seeking treatment for a bilateral recurrent temporomandibular joint dislocation. She was treated with a surgical procedure providing an antero-posterior osteotomy of the caudal portion of the articular eminence and the insertion of a calvaria bone graft, preserving the periosteum of the borders of the osteotomic beach. The newly remodeled articular eminence has an increased height, thus representing a barrier to condylar dislocation out of the glenoid fossa. No ostheosynthesis fixation was provided, and physiotherapic rehabilitation was started in the immediate postoperative phases to help the patient gain a good jaw function as soon as possible. Results: Such a technique showed to be effective, as during an 8-month follow-up span, the patient referred no recurrencies of joint dislocation. Jaw motion parameters maintained good over the entire follow-up period, and radiological assessments showed no signs of bone grafts reabsorption. Conclusions: The technique described in the present case report has some potential advantages over other surgical approaches to the treatment of recurrent temporomandibular joint dislocation that need to be assessed with future studies. © Springer-Verlag 2008.