Abstract
Although various methods of treatment including invasive and noninvasive therapies are available for the treatment of habitual temporomandibular joint dislocation, invasive therapy can be considered to be difficult in elderly patients or patients with systemic disorders. We recently experienced a case of anti-phospholipid antibody syndrome (APS) with repetitious cycles of remission and relapse of cerebral infarction, accompanied by recurrent TMJ dislocation.
The patient was a 34-year-old woman. She visited out facility with a chief complaint of recurrent bilateral TMJ dislocation. She had suffered from a cerebral infarction about one month before her first visit to our clinic. The woman was therefore treatment conservatively, with restriction imposed on the opening of her jaw. TMJ dislocation was alleviated with this therapy.
However, she suffered from another cerebral infarction 3 years later, accompanied with relapse of habitual TMJ dislocation. Again she received conservative treatment, enforcing restriction to her opening of her jaw. She however did not respond to this therapy since she was receiving anti-coagulant therapy for APS, invasive treatment was judged to be difficult for this case. We therefore advised the patient to accept the consequence of occasional TMJ dislocation and taught the patient and her family members how to manage TMJ dislocation upon onset. As a result, the frequency of TMJ dislocation decreased, and the patient was able to reduce and manage TMJ dislocation by herself. Thus, her condition was successfully controlled to the level not to cause any significant disturbance to her activities of daily living.
