dislocation of temporomandibular joint
Introduction
Introduction to temporomandibular joint dislocation The temporomandibular joint can be referred to as the mandibular joint. It is the only left and right bilateral joint joint of the maxillofacial region. It has certain stability and multi-directional mobility. Under the action of muscles, various important activities related to chewing, swallowing, language, and expression are produced. When the mandibular condyle moves beyond the normal limit, the joint is concave and cannot return to the position by itself, which is the dislocation of the temporomandibular joint. Clinically, it is mostly dislocation in the front and can occur on one side or both sides. basic knowledge The proportion of illness: 0.006% Susceptible people: no special people Mode of infection: non-infectious Complications: difficulty swallowing
Cause
Causes of temporomandibular joint dislocation
The anterior dislocation of the temporomandibular joint is often caused by a sudden opening of the mouth, such as laughing, yawning, or because of the mouth opening for too long. For the oropharynx examination or surgery, the use of the opener is excessive, so that the condyle is removed from the joint and concave. Dislocation occurs before the joint structure.
Prevention
Temporomandibular joint dislocation prevention
1. The key to prevention of this disease is to avoid trauma and treat recurrent dislocation. The disease mainly consists of large openings, injuries, etc., which cause the condyles to escape from the joints and cannot be re-determined by themselves. The muscles of the elderly may be abnormal and the ligaments may be loose. Recurrent dislocation.
2, the acute dislocation of the temporomandibular joint should be re-determined in time, and the bandage is used for craniofacial fixation, limiting the mouth opening for 2-3 weeks.
3. For patients with prolonged dislocation time, patients with masticatory muscles may be treated with local hot compress or chewing nerves before being re-established by hand.
4, when the various methods are re-invalidated, it can be considered to be re-established under general anesthesia, and even surgery is re-determined.
Complication
Complications of temporomandibular joint dislocation Complications, difficulty swallowing
The complications of this disease are relatively serious, mainly due to unclear language, saliva outflow, chewing, difficulty in swallowing, etc. In addition, some patients who are misdiagnosed or not treated in time may cause long-term joint dislocation, especially Psychiatric patients are prone to misdiagnosis and missed diagnosis.
Symptom
Temporomandibular joint dislocation symptoms Common symptoms Open state can not close the mouth and jaws of the jaws, mandibular prominence, swallowing difficulty, masseter muscle, mandibular dislocation
Abnormal jaw movement, open state can not be closed, language is unclear, saliva outflow, chewing, difficulty in swallowing, mandibular advancement, forehead shift, face shape correspondingly long, palpation can be found in the depression area before palpation, single When the lateral anterior dislocation, the lower jaw slightly extends forward, and the midline of the ankle is biased to the healthy side.
Examine
Examination of temporomandibular joint dislocation
The diagnosis of temporomandibular joint dislocation is relatively simple. The general patient knows that the temporomandibular joint is dislocated. The main reason is physical examination. The mandibular movement is abnormal. It is open and can not be closed. The mandible is extended and the forehead is moved downward. When palpation, the anterior tragus can be found in the depression area. When the unilateral dislocation is performed, the lower jaw is slightly extended forward, and the midline of the ankle is biased to the healthy side.
Diagnosis
Diagnosis and diagnosis of temporomandibular joint dislocation
diagnosis
1, dislocation side
It can be either unilateral or bilateral dislocation.
2, the time characteristics of dislocation
When the patient is in the temporomandibular joint dislocation, the dislocation time is within two weeks, which is called acute dislocation; the more than two weeks are called protracted dislocation; the repeated dislocation is called habitual dislocation.
3, dislocation direction
Because the articular recess forms a bony limitation on the upper and lower sides, anterior dislocation is most common, and dislocation in the other direction is only applied when the external force is applied to the lower jaw, accompanied by an ankle fracture. The mandible is a whole and the two joints are also The function of exercising as a whole, the internal displacement restriction of one side joint also helps to prevent the joint on the other side from dislocating outward, so the external dislocation of the joint only occurs when the contralateral side has a condylar neck fracture.
4, dislocation symptoms and physical symptoms
When the anterior dislocation is located in the anterior superior part of the joint nodule, in front of the tragus, between the condyle and the lateral condyle of the ankle joint, presenting a visual examination, palpation of the obvious triangular depression area, in the case of unilateral dislocation The mandible is stretched forward and deflected to the opposite side. Except for the affected side, the posterior teeth may be exposed early, the remaining teeth are open, the face is lengthened, other accompanying symptoms are open, the closed mouth is restricted, the affected joint area, facial pain, and chewing food cannot be chewed. Swallowing, language, and expression are all affected. Therefore, dislocation of the temporomandibular joint should be considered as a dental emergency. The anterior dislocation without a fracture can be diagnosed by clinical alone, and the dislocation in other directions is often accompanied by a fracture, which must be confirmed by X-ray examination.
Differential diagnosis
Dislocation of the temporomandibular joint due to violence should be differentiated from mandibular neck and neck fractures, the midline of the jaw is biased to the affected side (when unilateral fracture), or the anterior teeth are open jaw (when bilateral fractures), The neck has obvious tenderness, hematoma, and the fracture line can be seen by X-ray examination.
In addition, it should be noted that some people with unclear consciousness, mental illness, cerebrovascular disease and the elderly, because of joint capsule and ligament tissue and muscle relaxation and dislocation of the mandibular joint are not uncommon, can not ignore the simultaneous presence of this disease, psychiatric medication Reactive facial dementia and temporomandibular joint dislocation are easier to identify. Although some symptoms are similar, the latter is accompanied by mandibular joint dysfunction, and the occlusion relationship is disordered. X-ray shows that the condyle protrudes out of the joint socket, and the diagnosis is not difficult.
