Temporomandibular joint dislocation

1. Temporomandibular Joint
Dislocation

2. Dislocation of Jaws
• Dislocations occur when two bones that originally met at the joint detach.
• Dislocations should not be confused with Subluxation.
• Subluxation is when the joint is still partially attached to the bone.

3. Anatomy of TMJ

4. Anatomy of TMJ
• The joint involved with jaw dislocation is the TMJ.
• This joint is located where the mandibular condyles and the temporal bones meet.
• For the mouth to close, it requires the masseter, temporalis and medial pterygoid
muscle.
• For the jaw to open, it requires the lateral pterygoid muscle.

5. Pathophysiology
• Different positions of jaw dislocation
• Posterior
• Anterior
• Superior
• Lateral.

6. Pathophysiology
• The most common position is anterior it shifts the lower jaw
forward if the mouth excessively opens.
• This dislocation may happen bilaterally or unilaterally after
yawning.
• Affected muscles are the masseter and temporalis which pull up
on the mandible and the lateral pterygoid which relaxes
the mandibular condyle.

7. Pathophysiology
• Posterior dislocation is common for
people who get injured after being
punched in the chin.
• This dislocation will push the jaw back
affecting the alignment of
the mandibular condyle and mastoid.

8. Pathophysiology
• Superior dislocations occur after
being punched as the mouth remains
open. Since great force occurs in a
punch, the angle of the jaw will be
forced upward moving towards the
condylar head.

9. Pathophysiology
• Lateral dislocations move
the jaw away from the skull
and are likely to happen with
other jaw fractures

10. Symptoms
• Symptoms depends on the severity of the dislocation injury and how long the person
is inflicted with the injury.
• Symptoms of a dislocated jaw include
• Abnormal bite
• Difficulty in talking or moving jaw
• Not able to close mouth completely
• Drooling due to not being able to shut mouth completely
• Teeth are out of alignment

11. Symptoms
• Immediate symptom
• A loud crunch noise occurring right up against the ear drum. This is instantly followed
by excruciating pain, particularly in the side where the dislocation occurred.
• Short-term symptoms
• Mild to chronic headaches
• Muscle tension or pain in the face
• Pain in jaw and neck.

12. Symptoms
Long-term symptoms can result in
• Sleep deprivation
• Tiredness/lethargy
• Frustration
• Bursts of anger
• Depression
• Social issues relating to difficulty talking
• Hearing sensitivity
• Possible causing subsequent facial
asymmetry.

13. Symptoms
• Symptoms of a fractured jaw include
• bleeding coming from the mouth,
• unable to open the mouth wide without pain,
• bruising and swelling of the face,
• difficulty eating due to the constant pain,
• loss of feeling in the face (more specifically the lower lip)
• lacks full range of motion of the jaw.

14. Treatment
• Most temporomandibular disorders (TMDs) are self-limiting and do not get
worse.
• Simple treatment, involving self-care practices, rehabilitation aimed at
eliminating muscle spasms, and restoring correct coordination, is all that is
required.
• Nonsteroidal anti inflammatory analgesics (NSAIDs) should be used on a
short-term, regular basis and not on an as needed basis.

15. Treatment
• Treatment of chronic TMD can be difficult and the condition is best managed
by a team approach; the team consists of a primary care physician, a dentist,
a physiotherapist, a psychologist, a pharmacologist, and a surgeon.
• The different modalities include
• Patient education and self-care practices,
• Medication,
• Physical therapy
• Splints, psychological counselling, relaxation techniques,