2009 Volume 31 Issue 4 Pages 251-255
Purpose: Temporomandibular joint dislocation (TJD) may be associated with neurological disorders. However, little is yet known about this clinical entity. We reviewed our consecutive cases for clarification of the clinical features of TJD in stroke patients, and patient management. Methods: Patients entered on our dental-clinic database were reviewed. Results: Of 10 stroke patients with TJD, 6 manifested hemiplegia and 3 quadriplegia; one exhibited no weakness. All TJDs were anterior; 2 were unilateral and 8 were bilateral. They occurred at 12 days to 9 months (mean, 94.1 days) after stroke onset. Nine patients underwent manual repositioning; one had repositioning surgery. Conclusions: The mouth-closing muscles (masseter, temporalis, and medial pterygoid) raise the mandible to fit the temporomandibular joint, and they are innervated by a motor branch of the trigeminal nerve which also bilaterally innervates the supranuclear region. In stroke patients, these muscles may be weakened by unilateral pyramidal tract damage, suggesting that maintenance of the bite force depends on bilateral complete innervation. While TJD associated with stroke is rare, it should be borne in mind in order to facilitate early detection and repositioning.
