Open Access Emergency Medicine (Oct 2018)
Temporomandibular joint dislocation: a retrospective study from a Swiss urban emergency department
Abstract
Giorgos Papoutsis,1 Sylvana Papoutsi,2 Jolanta Klukowska-Rötzler,1 Benoît Schaller,3 Aristomenis K Exadaktylos1 1Department of Emergency Medicine, 2Department of Visceral Surgery and Medicine, 3Department of Cranio-Maxillofacial Surgery, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland Purpose: Temporomandibular joint (TMJ) dislocation is an uncommon and debilitating condition of the facial skeleton. The condition may be traumatic or nontraumatic, in an acute or chronic form, and with bilateral or monolateral expression. Patients and methods: In this study, conducted from May 2012 to July 2016, we retrospectively analyzed TMJ dislocations treated in the Department of Emergency Medicine, Inselspital, University Hospital Bern, University of Bern, by focusing on the following parameters: age, gender, reason, localization, frequency, and therapy. Results: Thirty-two patients were included. The mean age was 42.06 years and there was no predominant gender. Most cases of TMJ dislocation were nontraumatic (93.7%). Dislocations were mostly bilateral (59.4%) and appeared in a chronic situation and with repetitive events (62.5%). Thirty-one patients received conservative treatment, which consists of reposition of the TMJ with (38.7%) or without (61.3%) analgosedation. Only one patient needed surgical reposition due to previous surgical treatment. Conclusion: This is the first attempt to evaluate TMJ dislocations in Switzerland in an acute hospital setting. To our knowledge, there are no other studies that systematically analyze these injuries by focusing on the patients’ characteristics. Surgical reposition is only indicated in complicated and very rare situations. Conservative approaches are commonly used and should be exhausted before any surgery. Keywords: temporomandibular joint, emergency medicine, dislocations
