Management of Chronic Dislocation of the Temporomandibular Joint Accompanied by Neglected Mandibular Corpus Fracture

Abstract

Introduction: Trauma to the mandible can cause fractures and Dislocation of the temporomandibular Joint. Delayed treatment of the temporomandibular joint Dislocation can lead to complications such as facial deformity, limited mouth opening, and ankylosis of the temporomandibular Joint. This case report aims to discuss the treatment of chronic temporomandibular joint Dislocation accompanied by neglected fracture of the mandibular body. 

Case Report: A 19-year-old male patient came to Hasan Sadikin Hospital in Bandung, complaining of a slanted face on the left side two months after the accident. Extra-oral clinical examination revealed an asymmetrical face and left mandibular deflection. Intraoral examination found loose teeth 11-21, 32-31, and 43-44, mouth opening of about 2.5 cm, and anterior open bite occlusion. Radiographic examination showed multiple fracture lines of the mandible in the right region of teeth 43-44 and teeth 46-47, with Dislocation of the left condyle laterally out of the glenoid fossa. The diagnosis of this case was left chronic Dislocation of the Temporo Mandibular joint accompanied by a neglected fracture of the body of the right mandible. This case's treatment includes installing arch bar wiring, refracturing, open reduction and internal fixation (ORIF), coronoidectomy and left condylectomy. 

Conclusion: The management of chronic Dislocation of the temporomandibular Joint accompanied by neglected fracture of the mandibular body using refracturing, open reduction and internal fixation (ORIF), coronoidectomy, and condylectomy shows quite good results in mouth opening and function, but further physiotherapy treatment is needed to achieve optimal occlusion.

Keywords: Mandibular Fracture, TMJ dislocation, Coronoidectomy, Condylectomy, Open reduction