Abstract
We reported a case of obsolete dislocation of the temporomandibular joint (TMJ) in a patient with Parkinson's disease and cerebral infarction. This dislocation was treated with open reduction under general anesthesia and the occlusion was restored with denture.
The patient was a 67-year-old male. He sometimes had dislocation of TMJ since he was 59 years old. Every time he had dislocation of TMJ, the reduction was not done by himself but performed relatively easily at a clinic. In the middle of December 1999, he had dislocation of TMJ again. But he didn't go to the clinic for 2 weeks, because it was not painful. When he visited the clinic, the reduction became to be impossible. More than 6 months later, he came to our clinic. He suffered from difficulty of masticating and closing mouth. As an intra-oral finding, some molar teeth were missing. Panorama X-ray showed the dislocation of TMJ. Reduction of TMJ under general anesthesia was planned because reduction of TMJ with consciousness was impossible. Reduction of TMJ with only hands was impossible even under genral anesthesia. So open reduction was performed and succeeded. Concerning general anesthesia, propofol, fentanyl, and vecuronium were used. After the surgery, 2-weeks intermaxillary fixation and 2-weeks more restricton of opening mouth were done. Then denture was set for occlusal reconstruction.
There has been no recurrence of dislocation of TMJ. Also his Parkinson's disease has been controlled and cerebovascular attck has not happen.
