Despite a large number of conservative and surgical treatments described in the literature, manag... more Despite a large number of conservative and surgical treatments described in the literature, management of chronic dislocation remains a challenge. Different treatment modalities with variable results have been described for treating recurrent temporomandibular dislocation. The surgical procedures can be categorized under two main headings: procedures that increase freedom of movement of the condyles (like eminectomy) and those that prevent excessive movement of the condyles by obstructing the path. This last category of treatment includes several procedures: – Minimally invasive techniques: arthroscopic scarification of the retrodiscal tissue, sclerosing agent, and botulinum toxin injections – Hard tissue surgery: down-fracture of the zygomatic arch (Dautrey procedure), articular eminence grafting procedures, and metallic obstacles (bone miniplates, mesh, and screws) – Soft tissue surgery: capsular plication, lateral pterygoid myotomy and temporalis scarification, temporal fascial flap, and anterior disc positioning – Tethering procedures: limitation of joint translation by tethering the condyle to the zygomatic arch
BACKGROUND To describe the treatment of 2 long-standing chronic dislocation of the temporomandibu... more BACKGROUND To describe the treatment of 2 long-standing chronic dislocation of the temporomandibular joints (TMJs) and 1 chronic recurrent dislocation. METHODS This report describes the treatment of 3 patients; 2 with a long-standing chronic dislocation of the TMJ and 1 with a chronic recurrent dislocation. Duration of dislocation and anatomical considerations make the treatment challenging and controversial. The patients presented in this report all developed destruction of their condyles. They were successfully treated with total joint replacement with alloplastic devices. RESULTS All the 3 patients underwent successful surgery and recovery. Mandibular function and pain level were significantly improved. CONCLUSION Long-standing dislocation of the TMJ is rare. This condition can be successfully treated by resection of the damaged condyles and reconstruction with alloplastic total TMJ replacements.
Despite a large number of conservative and surgical treatments described in the literature, manag... more Despite a large number of conservative and surgical treatments described in the literature, management of chronic dislocation remains a challenge. Different treatment modalities with variable results have been described for treating recurrent temporomandibular dislocation. The surgical procedures can be categorized under two main headings: procedures that increase freedom of movement of the condyles (like eminectomy) and those that prevent excessive movement of the condyles by obstructing the path. This last category of treatment includes several procedures: – Minimally invasive techniques: arthroscopic scarification of the retrodiscal tissue, sclerosing agent, and botulinum toxin injections – Hard tissue surgery: down-fracture of the zygomatic arch (Dautrey procedure), articular eminence grafting procedures, and metallic obstacles (bone miniplates, mesh, and screws) – Soft tissue surgery: capsular plication, lateral pterygoid myotomy and temporalis scarification, temporal fascial flap, and anterior disc positioning – Tethering procedures: limitation of joint translation by tethering the condyle to the zygomatic arch
BACKGROUND To describe the treatment of 2 long-standing chronic dislocation of the temporomandibu... more BACKGROUND To describe the treatment of 2 long-standing chronic dislocation of the temporomandibular joints (TMJs) and 1 chronic recurrent dislocation. METHODS This report describes the treatment of 3 patients; 2 with a long-standing chronic dislocation of the TMJ and 1 with a chronic recurrent dislocation. Duration of dislocation and anatomical considerations make the treatment challenging and controversial. The patients presented in this report all developed destruction of their condyles. They were successfully treated with total joint replacement with alloplastic devices. RESULTS All the 3 patients underwent successful surgery and recovery. Mandibular function and pain level were significantly improved. CONCLUSION Long-standing dislocation of the TMJ is rare. This condition can be successfully treated by resection of the damaged condyles and reconstruction with alloplastic total TMJ replacements.
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Papers by David Psutka