Abstract
Since before Christ, Hippocrates' procedure was well known as a manual reduction procedure for acute temporomandibular joint (TMJ) dislocation. In this paper, the modified manual reduction procedure for acute TMJ dislocation is introduced.
First of all, the operator asks the patient to sit on the floor against the wall with his or her legs out straight. Then the operator stands facing the patient with his feet on either side of the patient's legs. The operator holds the patient's mandible with his thumbs on the bilateral occlusal surface of molar. Bilateral thumb pressure is exerted inferiorly and posteriorly. The operator leans his bodyweight forwards with straight arms when it is hard to replace the head of the mandible. After reduction of the mandible, it is common for the patient to bite the operator's thumbs. So the operator should move his thumbs outside of the teeth (to the oral vestibule). Restriction of mandibular motion for a few days is advisable.
Thirteen patients with acute TMJ dislocation underwent this manual reduction procedure. In all cases, the condylar head of the mandible was dislocated anteriorly.
The advantage of this manual reduction procedure is that even when the patient's muscle tension is strong and operator's physical strength is weak, it is not very hard to perform manual reduction of acute TMJ dislocation.
