Dislocation of the Mandible / Jaw Dislocation

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  • #10560
    Anonymous

    Predisposing Factors for Jaw Dislocation:

     

    • Most dislocations occur spontaneously on opening
      the mouth widely for yawn, dental work, during an
      epileptic seizure
    • Trauma may also produce dislocation
    • Trauma involving a downward force on partially
      opened jaw
    • Those with previous dislocations are at much
      greater risk for repeat dislocation
    • Shallow mandibular fossa may predispose to
      dislocation
    • Connective tissue diseases like Marfan’s or Ehlers-
      Danlos may have increased risk
    • May eventually result in osteoarthritis in TM joint

     

    Normally, the mandibular condyle lies in the mandibular
    fossa of the temporal bone
     when the mouth is closed and
    moves forward slightly when the mouth is open.

    When dislocated, mandibular condyle moves forward
    and lies forward (
    anterior) to the articular eminence
    which prevents its return to the 
    mandibular fossa of the
    temporal bone
    .

    #15529
    Anonymous

     Clinical Findings:


    • Dislocations of the lower jaw (mandible) tend to be 

      uncomfortable but not severely painful for the patient
    • The presence of a jaw fracture increases the pain
    • Patients are unable to close mouth completely
    • Difficulty speaking and, possibly, swallowing
    • Dislocations may be one-sided or both (unilateral or 

      bilateral)
    • The lower jaw comes forward (prognathic) 

      appearance to jaw when both are dislocated


    Imaging Findings:

    • Conventional X-ray is usually diagnostic
    • Mandibular condyle lies forward (anterior) to the 

      articulate eminence on one or both sides

    Treatment:

    #15598

      With Indore topping the charts leading the cities in the country with the maximum number of road accidents, more and more people are turning to dentists and maxillofacial surgeons for corrective surgeries. The data suggests that the accidents involve mostly youngsters who meet experts for correction in deformities.

     

    Between January 1, 2012 and May 15 about 296 accidents were reported in the city. Dr. Rashmi Saikhedkar of Rau dental hospital says, "Most of the road accident victims suffer from mandible (lower jaw) and zygomatic (cheek bone) injuries.” She said Maxillofacial surgery is a means to rectify soft tissue and hard tissue injuries in the lip area, cheeks, nose, jaws, and teeth.

     

    Of the total number of road accident cases, Dr. Samir Khanna, a city dentist has received several two-wheeler riders who either were drunk or without helmets for maxillofacial injuries. "Lower jaw fractures and nasal cartilage injuries are most common in road accident cases." he says. This year, the CHL Apollo hospital has received 57 cases of maxillofacial injuries, out of which 80% were due to road traffic accidents.

     

    Dr. Jaideep Singh Chauhan, maxillofacial surgeon at CHL Apollo hospital, says "The number of cases of maxillofacial injuries goes up by 8-10% every year. Most of these injuries can be averted if people start wearing helmets.” Similarly, Dr. Abhishek Jeenwal of Government district hospital says "Over-speeding among youngsters is a major reason for cases of facial trauma.

     

    During the year 2010 and 2011, the number of maxillofacial cases increased by 25%.

     

    Forty maxillofacial injury cases have already been registered in SAIMS dental hospital this year. ”In year 2010, we received 83 cases of maxillofacial injuries while the figure shot up to 134 in year 2011. More than 80% of these cases are because of road traffic accidents." says Dr. Tejas Motiwale, SAIMS Dental hospital.

     

    It must be noted that with increase in number of maxillofacial injury cases, the overall cost of a mandible, maxilla (upper jaw) and zygomatic surgeries has gone up.

     

    Dr. Sumit Jain of SAIMS dental hospital says "Plating and wiring are two vital processes in maxillofacial surgeries. We give patients an option to choose either steel or titanium plates. With increase in the cost of metal over the past two years, the overall cost of the surgery has gone up by 10-15%." Traffic expert, Prafulla Joshi says "There is a lack of public awareness. It is high time people start wearing helmets and put breaks on speed while riding in the city".

     
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