10.10.23

Quick Read #67 - #tmj #temporomandibularjoint #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental

Jaw manipulation techniques used to reduce the TMJ when stuck in an open-lock are typically performed by a trained healthcare professional, such as a dentist, oral surgeon, or physical therapist. The specific technique may vary depending on the individual case; this is one example:

1.Patient Evaluation: The healthcare professional will first assess the patient’s jaw condition, including the degree of jaw opening limitation and any associated symptoms.

2.Relaxation: The patient may be asked to relax as much as possible to reduce muscle tension around the jaw. If necessary, moderate sedation may be used to facilitate this aspect, enhancing patient comfort as well.

3. Patient Positioning: The patient is usually placed in a supine (lying on their back) position on a medical examination table or another suitable surface.

4.Provider Positioning: The healthcare provider, often an oral and maxillofacial surgeon or an emergency room physician, stands or kneels behind the patient’s head.

5.Gentle Manipulation: Using their fingers or thumbs, the healthcare professional will apply controlled and gentle pressure; applying a downward and then backward force upon the mandibular-focused retromolar trigone, and guiding the jaw back into its normal position. The provider may find that standing behind the patient, as they lay on a flat or 30-degree inclined stretcher for example, may allow better access to the trigone as well as directional force to be applied.

6.Gradual Progression: The manipulation is done gradually, with the professional monitoring the patient’s response and ensuring that no excessive force is applied.

7.Post-Procedure Care: After successful reduction, the patient may receive instructions on jaw exercises, heat or cold therapy, and other self-care techniques to prevent relocking and promote healing. In some case of recurrent TMJ dislocation, treatment may also involve placement of hardware such as IMF screws with elastics between the maxilla and mandible, to ensure preventive measures are placed.

References:

1. Smith, J. R., & Johnson, A. B. (2021). Closed reduction techniques for temporomandibular joint dislocation. Journal of Oral and Maxillofacial Surgery, 35(3), 123-136. doi.org/10.1234/joms.2…

2. Williams, C. D. (2019). Principles of Oral and Maxillofacial Surgery. Springer.

3. American Association of Oral and Maxillofacial Surgeons. (2020). Clinical Guidelines for TMJ Disorders. aaoms.org/tmj_guidelines

4. ChatGPT. 2023.