• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권3호
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• pp.182-187
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• 2022

Superolateral dislocation of the condyle is a rare mandibular fracture. The treatment goal is to return the dislocated condyle to its original position to recover normal function. This study reports on superolateral dislocation of the condyle with mandibular body fracture. The mandibular body was completely separated, and the medial pole of the condyle head was fractured. The condyle segment was unstable and easily dislocated after reduction. The temporalis muscle on the condyle segment might have affected the dislocation of the condyle. A coronoidectomy was performed to disrupt the function of the temporalis muscle on the condyle segment in order to successfully reduce the dislocated condyle. Coronoidectomy is a simple procedure with minimal complications. We successfully performed a coronoidectomy to reduce the superolateral displaced condyle to its original position to achieve normal function. Coronoidectomy can be effectively used for reduction of superolaterally displaced condyles combined with severe maxilla-mandibular fractures.

• Journal of Oral Medicine and Pain
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• 제42권2호
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• pp.44-48
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• 2017

Chronic temporomandibular joint dislocation is defined as an acute dislocation that cannot be reduced or that recurs for more than one month. The management of dislocation depends on patient status and the duration of dislocation and ranges from conservative reduction to a surgical approach. In the present cases, a 64-year-old male was referred to our department for treatment of chronic dislocation for 6 weeks. The dislocation might be occurred by endotracheal intubation. A 70-year-old female was referred to our department with repeat right condyle dislocation after reduction of dislocation at a local clinic. When she visited for later treatment of new dentures, her condyle had been dislocated again for several weeks. In both cases, we tried to treat the dislocation with several manipulations, which were unsuccessful. Finally, chronic dislocation was successfully treated by surgical traction under general anesthesia without relapse. Surgical traction is a simple, effective option with the lowest morbidity of surgical procedures for chronic dislocation when conservative reduction is unsuccessful.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.14.1-14.10
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• 2019

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권5호
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• pp.238-241
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• 2013

Lateral and superior-lateral dislocations of the intact condyle are a rare complication, following traumatic insult to the mandible. We report an unusual case of a 54-year-old male patient who experienced both types of dislocations of the intact condyles with symphysis fracture following a road-traffic accident. Under general anesthesia, conventional manipulation was unsuccessful in relocating the condyles into the glenoid fossa. After applying a percutaneous traction force, using a bone traction hook placed at the sigmoid notch, the displaced intact mandibular condyles were repositioned, and the symphyseal fracture was finally reduced and fixed. The mouth opening was within normal limits, and favorable occlusion was confirmed one month postoperatively. To our knowledge, this is the first case of dislocation of both intact condyles--associated with symphysis fracture--being reduced with bone traction hook.

• Journal of Korean Dental Science
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• 제1권1호
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• pp.10-14
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• 2008

The fracture of facial bone usually accompanies alveolar bone fracture and dislocation or fracture of teeth. Thus, aside from the reduction of fracture, the reconstruction of occlusion through the rehabilitation of lost teeth should be considered. The dislocation of tooth after trauma accompanying alveolar bone fracture needs bone grafting in case of implant treatment. Although autogenous bone graft shows good prognosis, it has the disadvantage of requiring a secondary surgery. This is a case of a mandibular condyle head fracture accompanied by alveolar bone fracture. The condylar head fragment removed during open reduction was grafted to the alveolar bone fracture site, thereby foregoing the need for secondary surgery.

• 치과방사선
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• 제25권2호
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• pp.471-482
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• 1995

Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age. They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group(83％). 2. Fallen down(54％) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to paipation09 cases). Mouth opening limitation07 cases), swelling(7 cases), malocclusion(3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients(44％). Condyle fractures with symphysis fracture(9 patients, 39％), condyle fractures with ascending ramus fracture(2 patients, 9％), condyle fracture with mandibular body fracture(1 patient, 4％), and condyle fractures with mandibular angle fracture(1 patient, 4％) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, dispiacement(17 cases, 66％) was most common. Dislocation(5 cases, 19％) and deviation (4 cases, 15％) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual condylar shape in 23 cases and with prominently different shape in 3 cases.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권5호
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• pp.305-309
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• 2012

Temporomandibular joint (TMJ) subluxation and dislocation are uncommon but very unpleasant and distressing conditions to patients. Subluxation of the TMJ is an excessively abnormal condylar excursion secondary to flaccidity and laxity of the capsule. When the condyle head excurses anterior to the eminence upon wide opening, it can return to the fossa by self-manipulation or non-surgical conservative reduction. Surgery is recommended if a complete dislocation, so-called open lock, occurs as a chronic or recurrent protracted condition that cannot be reduced voluntarily. A range of surgical procedures can be performed to limit condylar hypermobility inclusing soft tissue tethering, creation of articular obstacles, removal of mechanical blockade and augmentation of articular eminence using different kinds of grafts. In the present case, a 74-year-old woman was diagnosed with a chronic TMJ dislocation that had lasted for 6 months. Bilateral condylectomy was performed and the post-operative results were good without functional limitations or recurrence.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.156-162
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• 2014

Dislocation of temporomandibular joint (TMJ) is troublesome condition which was most commonly shown far anteriorly displaced mandibular condyle to the articular eminence, thereby make it impossible to close one's mouth. It is often referred to as 'open lock' in clinically. Although anatomical modification of the articular eminence through eminectomy has been considered most satisfactory and efffective treatment for managing the recurrent dislocation, it seldom performs clinically due to its invasiveness and patient's reluctance. We thought a shortterm intermaxillary fixation could be of benefit to the patient suffering from recurrent dislocation. A 21-year-old male patient with recurrent TMJ dislocation which had developed after excessive mouth opening, was successfully treated with intermaxillay fixation using microimplant for 2 months. It is more conservative and less complicated method than eminectomy in treating recurrent TMJ dislocation. Transient intermaxillary fixation using microimplant and elastics could be one of treatment options for recurrent TMJ dislocation.

• Journal of Oral Medicine and Pain
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• 제39권4호
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• pp.152-155
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• 2014

Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.238-242
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• 2000

Recurrent mandibular dislocation is frequent morbidity of temporomandibular joint relatively. There are many etiologic causes in TMJ disorders but, difficult to find obvious one. Various treatment methods have been utilized for a mandibular dislocation. It is categorized into two groups broadly - nonsurgical or surgical methods. The basic rationale of the surgical method is to allow free movement of the condyle by reducing height of articular eminence or to limit anterior excessive movement of the condyle by increasing height of articular eminence or soft tissue anchoring procedure. In this case, 69 year-old woman was treated by augmentation of the articular eminence with mandibular symphysial bone graft leading to osteosynthesis without difficulty. As a result, favorable postoperative outcome was obtained functionally without any complication or recurrence.