Anterior dislocation of head of mandible: diagnosis and treatment

• Main Authors: Luiz Makito Osawa Gutierrez, Thiago Kreutz Grossmann, Eduardo Grossmann
• Format: Article
• Language: English
• Published: Sociedade Brasileira para o Estudo da Dor
• Series: Revista Dor
• Subjects: clinical and surgical treatment; dislocation of head of mandible; temporomandibular joint
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-00132011000100014&lng=en&tlng=en

BACKGROUND AND OBJECTIVES: To study the etiopathogeny and diagnosis of anterior dislocation of head of mandible (ADHM), as well as its therapeutic indications: conservative and surgical treatment. CONTENTS: ADHM is characterized by its position anterior to the articular tubercle, configuring an anatomic and functional disharmony where the patient is unable to close the mouth. It may be related to abnormal activity of mastication muscles during mouth opening, to the act of yawning and even to the act of guffawing. Treatment modalities vary from conservative to surgical techniques, depending fundamentally on the complexity and periodicity of the problem. The first options are conservative techniques for immediate reduction, temporary relief or stabilization of the joint; when they fail or the treatment is impossible, surgical techniques may be used. CONCLUSION: Although uncommon in epidemiological terms, ADHM is still a challenge for health professionals due to its complexity and, at the same time, because it is unforeseeable. The treatment of choice depends on professionals' experience and skills. To date, we lack longitudinal studies and randomized clinical trials to compare the therapeutic efficacy of each modality.