Abstract
A case involving difficulty with manual reduction of anterior dislocation of the temporomandibular joint (TMJ) in a patient with Parkinson’s disease is presented. The dislocation was reduced using continuous reduction provided by leverage obtained using bite blocks and elastic traction.
The patient was an 81-year-old male with Parkinson’s disease. In the past, the patient had repeatedly experienced bilateral habitual dislocation of the TMJ. In February 2008, the patient developed severe aspiration pneumonia requiring a tracheostomy under general anesthesia, whereupon dislocation of the TMJ was noted.
Upon initial examination in our department, dislocation of the TMJ was treated by manual reduction. Despite dislocation being noted again the following day, the patient was receiving respiratory care in the intensive care unit, so the TMJ remained dislocated until the patient could be seen again 5 days later. Reduction failed despite repeated attempts at manual reduction. Open reduction under general anesthesia would have been difficult given the patient’s general condition, so continuous reduction was performed using intermaxillary traction. After 4 days, the heads of the condyles had been repositioned, and occlusion had been restored. To prevent additional dislocations, intermaxillary fixation was performed. The patient’s course was satisfactory, and additional dislocations were not noted.
