Mandibular and Temporomandibular Joint Injuries

Author: Jonathan Whittaker / Editor: Jonathan Whittaker / Reviewer: Shanthi Siva, Pragya Mallick / Code: / Published: 09/06/2021

After completing this session you will be able to:

• Identify the anatomical factors that contribute to the pathophysiology of mandibular and temporomandibular joint injury
• Identify common findings in the history and examination which help to discriminate mandibular fracture and dislocation
• Formulate a strategy for appropriate investigation of mandibular injury
• Recognise temporomandibular joint dislocation and describe a standard reduction technique

References:

1. Boole JR, Holtel M, Amoroso P, Yore M. 5196 mandible fractures among 4381 active duty army soldiers, 1980 to 1998. Laryngoscope. 2001 Oct;111(10):1691-6. PMID: 11801927.
2. Lowery LE, Beeson MS, Lum KK. The wrist pivot method, a novel technique for temporomandibular joint reduction. J Emerg Med 2004;27:167-170.
3. Ugboko VI, Oginni FO, Ajike SO, et al., A survey of temporomandibular joint dislocation: aetiology, demographics, risk factors and management in 96 Nigerian cases. Int J Oral Maxillofac Surg. 2005 Jul;34(5):499-502. PMID: 16053868.
4. Rashid A, Eyeson J, Haider D, van Gijn D, Fan K. Incidence and patterns of mandibular fractures during a 5-year period in a London teaching hospital. Br J Oral Maxillofac Surg. 2013 Dec;51(8):794-8. PMID: 23735734.
5. Hung YC, Montazem A, Costello MA. The correlation between mandible fracture and loss of consciousness. J Oral Maxillofac Surg 2004;62:938-94.
6. Chong VFH, Fan YF. External auditory canal fracture secondary to mandibular trauma. Clin Radiol2000;55:714-6.
7. Malhotra R, Dunning J. The utility of the tongue blade test for the diagnosis of mandibular fracture. [accessed 2nd June 2008]
8. Schwab RA, Genners K, Robinson WA. Clinical predictors in mandibular fractures. Am J Emerg Med1998;16:304-5.
9. Charalambous C, Dunning J, Omorphos S et al., A maximally sensitive clinical decision rule to reduce the need for radiography in mandibular trauma. Ann R Coll Surg Engl 2005;87:259-263.
10. Begum P, Jones S. Radiological diagnosis of mandibular fracture. [accessed 2nd June 2008].
11. Nair MK, Nair UP. Imaging of mandibular trauma: ROC analysis. Acad Emerg Med 2001;8:689-695.
12. Luyk NH, Larsen PE. The diagnosis and treatment of the dislocated mandible. Am J Emerg Med1989;7:329-335.
13. Roth FS, Kokoska MS, Awwad EE et al., The identification of mandible fractures by helical computed tomography and panorex tomography. J Craniofac Surg 2005;16:394-9.
14. Andreasen JO, Jensen SS, Schwartz O et al., A systematic review of prophylactic antibiotics in the surgical treatment of maxillofacial fractures. J Oral Maxillofac Surg 2006;64:1664-8.
15. Totten VY, Zambito RF. Propofol bolus facilitates reduction of luxed temporomandibular joints. J Emerg Med1998;16:467-470.
16. Shun TA, Wai WT, Chui LC. A case series of closed reduction for acute temporomandibular joint dislocation by a new approach. Eur J Emerg Med 2006;13:72-5.
17. Chen YC, Chen CT, Lin CH et al., A safe and effective way for reduction of temporomandibular joint dislocation. Ann Plast Surg 2007;58:105-8.
18. Boffano P, Roccia F, Gallesio C, et al., Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study. Craniomaxillofacial Trauma & Reconstruction. 2014;7(4):280-283.
19. Toles K, Trick of the Trade: Extra-oral reduction technique of anterior mandible dislocation. ALiEM, 2016.
20. Core EM, TMJ Dislocation Reduction Techniques. 2016.