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Habitual dislocation of lower jaw
Last reviewed: 23.04.2024
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[What causes the usual dislocation of the lower jaw?
The cause of the usual dislocation of the lower jaw can be rheumatism, gout and other organic pathological lesions of the temporomandibular joints. Often the usual dislocations are observed in epileptics, as well as in persons who have suffered encephalitis and suffer from clonic convulsions. A habitual dislocation of the lower jaw can also occur as a result of improper treatment of an acute dislocation of the lower jaw (its lack of immobilization for a certain time after repositioning). As a result, there is a significant stretching of the joint capsule and the ligamentous apparatus of the joint.
Outcomes of the habitual habitual dislocation of the lower jaw
Conservative treatment of habitual dislocation of the lower jaw is usually effective. If, in spite of the conservative treatment of the habitual dislocation of the lower jaw, the underlying disease progresses, one must resort to a surgical method of eliminating the dislocation (an increase in the articular tubercle).
Treatment of habitual dislocation of the lower jaw
Treatment of the usual dislocation of the lower jaw is conservative or surgical.
Conservative treatment of the habitual dislocation of the lower jaw includes the therapy of the underlying disease (rheumatism, gout, polyarthritis) and orthopedic treatment, for example wearing a special tire (on the upper jaw) with a pelot resting on the mucosa of the anterior margin of the mandible (KS Yadrovoy's bus) , or the apparatus of Yu. A. Petrosov.
A very simple and easy-to-use device for limiting the lower jaw leads is proposed. On the small molars of the upper and lower jaws (and in their absence - on large molars or fangs) two stamped metal crowns are made. On the vestibular surface of each crown, a section of an injection needle 3 mm in length with an internal diameter of 0.6-0.7 mm is soldered. The needle pieces are soldered at an angle of about 45 ° with respect to the chewing surface. Ready tooth-crowns are cemented on the teeth. Having fused one of the ends of a 10-15-centimeter piece of monolithic polyamide yarn of the appropriate diameter (0.6-0.7 mm) to the formation of a clavate expansion, spend it from behind-ahead through the lower tube, and then from front to back through the upper tube. Having determined the required length of the thread, cut off the excess bulky probe by 3 mm anteriorly from the posterior end of the upper tube and convert the protruding portion of the filament (by the same heated tool) into a clavate expansion. If further there is a need to reduce or increase the amplitude of movement of the mandible, this is easily done by changing the length of the polyamide thread.
As a result of the limitation of mobility in the joint, there is a reduction in the size of the joint capsule, the ligamentous apparatus, the condition of the meniscus improves, the joint is strengthened.
Surgical methods of treatment of habitual anterior dislocations involve either an increase in the height of the articular tubercle, or deepening of the mandibular fossa, or strengthening of the ligament capsular apparatus. For example, Lindemann increases the height of the articular tubercle due to its cleavage and retraction downwards on the front leg; AA Kyandsky forms a bone spur in front of the submandibular fossa , backed by cartilage (due to transplantation of cartilage under a small bone-periosteal flap). Konjetzny moves the articular disc from the horizontal position to the vertical anterior to the head of the lower jaw.
Thanks to these techniques, the mandibular fossa is deepened and a barrier is formed in front of the condylar process.
Some surgeons remove the meniscus, strengthen it with sutures, reduce the size of the capsule or strengthen it by transplanting the fascia.
However, the most effective and relatively simple method is to increase the articular tubercle according to AE Rauer. In this case, a soft tissue incision is made in the region of the posterior part of the zygomatic arch and a piece of costal cartilage taken from the operated patient is inserted under the periosteum in the articular tubercle region ; for this purpose can also be used canned allochryashch, which further simplifies the operation.