Dislocation of the jaw: what to do? symptoms and treatment of dislocation and subluxation

Dislocation of the jaw: treatment, symptoms and first aid

One of the most common injuries is a dislocation of the jaw.

Often there is a dislocation of the jaw when yawning, during a cry with a wide opening of the mouth, while eating with biting off a large piece of solid food, with tooth treatment or prosthetics in other similar circumstances. It is often recorded in the female part of the population, perhaps it is related to the features of the structure.

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Structure

The temporomandibular joint (TMJ) is a hinge-like junction between the head of the temporal bone and the joint surface of the lower jaw. In women, the depression of the temporal bone is flatter than in men, this is the reason for the more frequent dislocation of the female sex.

The peculiarity of this joint is that the joints on the left and right should perform the work synchronously, as they are a unified system, otherwise the jaw dislocation will occur. To understand the principle of damage, it is necessary to consider the anatomical structure of the joint.

The joint is formed by the ellipsoidal head of the lower jaw, the head enters the articular mandibular fossa of the temporal bone. In size, the fovea exceeds the head more than 2 times, which makes it possible to perform more amplitude motions in the TMJ. It consists of two departments:

1. Anterior or intracapsular. This department is limited in front of the slope of the hump of the joint, behind it there is a stony-tympanic gap, outside - the root of the appendage of the malar bone, and medially there is an axis of the wedge-shaped bone - all these formations are block-limiters and stabilizers, preventing dislocation TMJ;
2. Back or extra-capsular. The place where the articular surfaces most closely adjoin each other, because of the increased load and excessive friction, the space of filling with a special fiber, which is characterized by high elasticity and elasticity for the performance of the damping function, which prevents the concussion of adjacent contours the joint.

The joint cavity is divided into 2 chambers having their own synovial cavities, which are interconnected by interarticulate cartilage or disk.

The disk is a connective tissue formation formed by a cartilaginous fibrous tissue, whereby it is a flexible formation that participates in the movement of the lower jaw back and forth thanks to offset disk.

Joint ligaments are divided into extra- and intracapsular. The main function of intracapsular - fixation of the disc, and extra-capsular - stabilization of the joint itself, due to this limited movements of the lower jaw, which prevents the formation of dislocation.

Varieties

It is necessary to distinguish subluxations and dislocations. So, the subluxation of the TMJ - characterizes the partial loss of the head from the joint cavity of the temporal bone.

While the dislocation of the temporomandibular joint is a complete exit from the joint cavity of the head of the lower jaw.

Dislocations of the jaw joint can be divided according to the time of training on:

• Acute. Uncontrollable up to 10 days after a dislocation injury;
• Stale. Appeal to a specialist occurred a week and a half after the formation of a dislocation.

In terms of the number of adjacent entities involved in the lesion, the injury is divided into:

1. Simple. Isolated dislocation;
2. Complicated or complicated. Damage to ligamentous apparatus, articular capsule, skin, muscle fibers, vascular and nerve formations.

The same dislocation of the jaw is divided into:

• Traumatic dislocation of the jaw - formed as a result of the impact on the joint from the outside;
• The habitual dislocation of the jaw (also called chronic dislocation) - is a recurrence of trauma after excessive overstrain ligamentous apparatus and their insolvency, because of what the basic function of stabilization and limitation of movements suffers the joint.

Depending on the nature of the traumatic impact, the lesion can be divided into:

1. Unilateral and bilateral dislocation;
2. Posterior, lateral or anterior dislocations - depending on the direction of the head exit from the joint fossa of the temporal bone.

It is necessary to distinguish the dislocation of the joint, from the dislocation of the disc. The latter occurs due to a violation and weakening of the cartilage connection to the head of the lower jaw, or as a result of spasm (contraction) of the lateral pterygoid muscle.

First aid: what to do

The algorithm for providing pre-hospital care to the injured person with suspected dislocation of the lower jaw includes the following items:

1. The call of the SMP brigade;
2. Prohibition of the patient to speak, try to open or bury his mouth, for more reliable immobilization, the jaw is tied with a kerchief or a handkerchief; strengthens from bottom to top and from front to back with two pieces of cloth;
3. The mouth, which is always open during dislocation, is covered with an absorbent cloth, which will protect against getting dirt and dust, as well as reduce solvation - separation of saliva;
4. If possible, it is allowed to inject an anti-inflammatory and antispasmodic drug intramuscularly for analgesia and to reduce inflammation;
5. It is recommended to put an ice pack on the place of the proposed dislocation to reduce the edema and inflammatory component due to the reflex narrowing of the vessels.

Which doctor should I go to

If the jaw dislocated, it is best to consult a doctor of the maxillofacial surgical department.

Maxillofacial surgeons are best acquainted with pathology, only they are able to eliminate the habitual dislocation, which requires the treatment of surgical intervention.

Dentists often face dysfunction, as dental dislocation is possible with dental manipulations and doctors are obliged to provide on-site assistance.

There, trauma doctors will be able to determine by the radiograph the nature of the injury and fix the jaw.

Symptoms and signs

Acute sprains are characterized by the following clinical symptoms:

• The victim's mouth is open, the joint is "jammed it is not necessary to forcefully close and open the mouth, in order to avoid deterioration;
• The speech of the patient is unintelligible, difficult, there are hissing and whistling sounds;
• Hypervisation - increased salivation. It is a protective reaction, since saliva contains biologically active substances that destroy the pathogenic microflora, as well as saliva serves for mechanical cleansing of the oral cavity.
• With unilateral defeat - the patient's face is expressed asymmetrically, with bilateral - perhaps a symmetrical arrangement of the lower jaw without distortions;
• During palpation, the doctor diagnoses "empty" pitches of the temporal bone, and visually there is a bulging of the skin under the zygomatic arch - there is a head;
• The patient feels the increase of the bol during involuntary movement, during the attempt to speak;
• Feeling of the joint is painful, swelling is noted, local warming of the skin, redness is possible;
• If the vessel is damaged, there may be a sign of balloting (indicating the accumulation of fluid in the joint cavity);
• With the defeat of nerve fibers - skin paresthesia is possible: sensation of numbness, itching, "crawling etc.

In chronic dislocation, the symptoms are significantly different: they are not characterized by a pain reaction, only discomfort, there is no pronounced inflammation.

Patients practice self-correction of the jaw, in view of the high incidence of seizures.

When the disc is dislocated - the jaw is mobile, but the movements are accompanied by clicks, the movements are painful, the amplitude is limited. All signs of inflammation are noted.

Treatment

Previously, the joint is anaesthetized with the help of infiltration around the essence of solutions of novocaine or lidocaine.

The doctor's thumbs, wrapped in gauze, are inserted into the oral cavity, the remaining ones wrap around the corner of the lower jaw.

The jaw is pulled back and forth with a sharp movement, and a click is heard.

Then the patient is imposed a sling-like bandage, which is contraindicated to be removed during the next two weeks, anti-inflammatory drugs are prescribed to prevent inflammatory changes and anesthesia. The food of such a patient should be ground by a blender, preferably through a tube, without solid components, not burning.

Operation

The operation is resorted to in severe cases or for the correction of chronic dislocation.

Severe dislocation is accompanied by damage to nerve fibers, infringement of soft tissues, damage to blood vessels and accompanied by bleeding.

Apply the method of arthroscopy (performed like laparoscopy on the organs of the abdominal cavity, only optical equipment is found in the joint cavity).

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Arthroscopy is the only subject of choice for the uncontrollable dislocation of the cartilaginous disc. During the intervention, the lavage (washing with saline solution) is removed by the inflammatory components - effusion.

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The damage is inspected: the infringement of nerve and soft-tissue components is eliminated, repositioning and fixing disk, expansion of the joint gap by hydraulic method, suturing of bleeding vessels and damaged capsules the joint.

At home

At home, the dislocation of the jaw can be corrected by the Blehman-Gershuni method. This manipulation is taught to members of the family of a person suffering from a constant recurrent dislocation.

To do this, it is necessary to grope the displaced process of the lower jaw, then press down and then down. Reposition is quick and relatively painless.

The click sound is indicative of the correct direction.

After repositioning, it is recommended that the sling dressing is applied and the maximum restriction of movements within 5 days. If the condition worsens: the appearance of pain in the temporal region, increased swelling, or other symptoms, you urgently need to contact a dentist or maxillofacial surgeon.

At home, special orthopedic caps are used for the treatment of chronic dislocation - peculiar tires on the teeth.

In parallel, anti-inflammatory therapy is performed, and sometimes intra-articular hydrocortisone (hormonal drug) is administered in the outpatient setting of a dental clinic.

Rehabilitation and recovery

Rehabilitation after repositioning of the dislocation involves immobilization and complete unloading of the temporomandibular joints lasting from two to three weeks.

This is achieved by wearing a band that supports the lower jaw, special caps, which limit the opening of the mouth, as well as a diet with the complete exception of hard and hot food.

You can also carry out massages using hydrocortisone ointments, as well as creams and gels with anti-inflammatory effect (Diklak-gel, DIP-release and others). In the recommendation for recovery, short-term courses of physiotherapy can be used to improve blood circulation and accelerate recovery.

Effects

The most formidable complication of acute dislocation is the chronization of the process and the transition to the familiar phase. This causes difficulties and worsens the quality of life of the patient, since in the conditions of regular relapses, there is little effort to create a pathology.

Also, the development of arthritis of the temporomandibular joint may be the consequences of the dislocation. There are phenomena of bursitis - accumulation of fluid effusion with fibrin films inside the joint capsule, which subsequently, with prolongation and refusal of treatment, can lead to contractures.

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Dislocation of the jaw: symptoms, first aid, methods of correction and complications

Among the pathologies of the maxillofacial region, a dislocation of the jaw occupies a separate place. It can be found both among the able-bodied population, and among pensioners. And in women it is observed more often, and it is connected with anatomical features.

Anatomy of the structure of the lower jaw

The jaw-chewing area is anatomically composed of a movable lower jaw, a fixed upper jaw part and a number of masticatory muscles, which realize their interaction by means of movements in the jaw the joint.

The mandibular temporal joint is located in the recess of the pit of the joint-temporal bone and is the end of the mandibular bone. That is why the temporal and mandibular bones are mobile.

Thanks to this structure, we can communicate and chew - the lower jaw can move up and down and left to right.

Causes of dislocation of the jaw

Trauma of the jaw bone is many: dislocation, subluxation, fracture. In fact, such damage a person can get even when chewing food or yawning. A disease of the joints, including the presence of arthritis, only increase the chances of getting such trouble.

In any case, the correction of the dislocation of the jaw should be done immediately after its appearance - only in this way can various complications be avoided and the tires fixed for a long period.

As a rule, the displacement of the lower part occurs at the moment when the articular head falls out of the fossa of the joint.

If such a trouble occurs regularly, then a person constantly gets such an injury.

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First of all, this may indicate that its ligaments are weakened or the fossa of the joint is too small.

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How to determine if your jaw is biased, see the video.

The subluxation differs in that the head is partially displaced while remaining in the pit. In this case, the victim himself can help himself.

For the lower part to shift, it must be affected by a force that exceeds the force of the ligaments that hold it in the bag.

Different people have different strengths of joints. For some, even a strong blow to the lower part will not harm - there will be only a bruise or bruise. And some people need one slap to remove it. And all because their ligaments are weakened and there is no necessary force of attraction of bones.

In addition, the cause of subluxation can be such diseases as convulsive syndrome, epilepsy, the consequences of the transferred encephalitis.

The main reasons for the dislocation of the jaw are:

• injury;
• excessive opening of the mouth during screaming, yawning, vomiting, nibbling, with dental procedures;
• a bad habit to bite off solid objects (nuts, bottles, etc.);
• congenital anomaly of the articular bag (it can be shallow, and the head easily jumps out of it).

How to distinguish from a fracture: symptoms of dislocation and subluxation

All jaw injuries are accompanied by a speech disorder. Depending on the type of displacement, the symptoms also vary.

When fresh traumaticbilateral dislocationwith the displacement of the mandibular forward, the following symptoms are observed:

1. The mouth is wide open.
2. The chin is shifted down and forward.
3. Copious saliva.
4. In the parotid zone there are severe pains.
5. Due to the shift of the chin down the face is lengthened.

Whenunilateral dislocationobserve such symptoms:

1. the chin is displaced;
2. the mouth is half open;
3. the central incisors and bridles of the lower lip are shifted to a healthy side;
4. The lower part can only move down;
5. under the cheekbone there is an obvious protrusion;
6. in the parotid zone there is acute acute pain;
7. on the goathead of the ear there is a sinking.

The posterior dislocation of the mandibular bone, which in most cases is the result of a stroke in the chin, while the lower part is shifted back.

Often, this condition is accompanied by a fracture of the bone wall of the auditory canal and rupture of the joint capsule, which can cause bleeding from the outer ear.

Symptoms of habitual displacement are different from acute dislocation. Habitual trauma can occur in the patient several times a day. At the same time, they are not accompanied by severe pain, they can self-correct and do not affect the psychological state.

With a fracture, the posterior edges of the lower jaw are more hanging and distal (closer to the center) than when displaced. Moreover, palpation reveals their deformation, and the patient experiences localized (in the place of fracture) pain.

Visually, what happens to the jaw in case of a dislocation, as well as about the difference between one-sided and two-sided dislocations, see in the video.

Classification of jaw displacements

In terms of the degree of injury, the timing of the displacement, the severity of the injury and the shift line, the dislocations can be classified as follows:

1. Full and incompletedislocation (subluxation) of the jaw have their own symptoms. If, at full offset, the joints of the joint surfaces are completely broken and the head is outside the mandibular fossa, then with subluxation, the connection of the articular surfaces partially saved. If the dislocation is accompanied with a fractured condylar processus (processus condylaris), then it is fractured.
2. Depending on the causes and time of occurrence,acquired and congenitaldislocations. And the origin of the acquired are pathological, traumatic or permanent.
3. Depending on the displacement line, the dislocations are divided intofront and rear.
4. By symmetry, the displacements are divided intoone-sided and two-sided.
5. If more than 10 days have elapsed since the onset of the dislocation, it is consideredacute. If the bias is older, weeks isoldorchronicdislocation.
6. If there are no injuries of the skin during dislocation, it is consideredplain. If there are ruptures of tendons, vessels, skin, soft tissues, this offset is consideredcomplicated.

First aid

Many people who face a dislocation of the jaw are lost and do not know what to do in this case.

To this experts give such advice on first aid:

1. First of all, the patient must be reassured and forbidden to move his jaw.
2. Then fix the bottom of any improvised means (bandages, scarves, other materials from the fabric). And the lower part should be fixed motionless for the entire time of transportation to the medical institution.
3. With severe pain, you can enter painkillers (ketone, paracetamol, analgin).

Diagnostics

If in your environment there is a person for whom a dislocation of the jaw is a familiar phenomenon, you need to know which doctor is treating.

Most often, the jaw is corrected without anesthesia, but in some cases, anesthesia may be needed.

First of all, the doctor must determine whether unilateral and bilateral are dislocations or fractures of the condylar processes. In this case, the X-ray method is used.

When dislocated on the X-ray, the condylar (upper) process will shift toward the anterior caldera of the tubercle. If the fracture is determined by a violation of the integrity of the bone.

Methods of correcting the jaw

Self-cope with the dislocation of the jawdo not recommend: how to correctly put it in place, only the doctor knows.

However, you can see the procedures for the correction below.

Blechman-Gershuni's method

This technique provides for two options for repositioning: directly in the oral cavity and outside.

At the first the doctor in the mouth gropes for the displaced coronal processes of the jaw and presses them simultaneously down and back. The joint thus returns to its place.

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The external method is more comfortable. The doctor discovers the same processes outside (near the bones and arches of the cheekbones). The direction of movement is the same - down and back. As a result, the head returns to its normal position. This method is simpler and faster, so they prefer to use it.

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In principle, such a method can be learned even without special education and set the jaw in a couple of seconds. Especially relevant such skills will be for those who have such occasions in the family or close circle, and first aid can be provided at home.

The Way of Hippocrates

In order to correct the bi-lateral displacement, the person is seated in such a way that the lower jaw is located at or slightly below the elbow joint of the doctor (the arm should be lowered). Preliminary, on both sides, local anesthesia is carried out according to Bershe-Dubov or Egorov (or general anesthesia).

The doctor puts his thumbs on the chewing surfaces of the lower molars, and the rest is captured by the part from below.

Then the chin is moved upward and the jaw bone is moved back into the bag on the posterior slope of the articular tubercle.

Method Popescu

This method of correction is performed under local anesthesia or under anesthesia. The patient lies on his back.

First, the doctor attaches tight gauze beads 2 cm in diameter between the molars of the affected person. Then the chin is pressed from below (from which it rises upward) and from the front (the direction of pressure is back). As a result, the head moves into the articular bag.

In some cases this method may not help and surgical intervention will be required. After the operation, physiotherapy procedures and the use of special removable devices will be prescribed.

Treatment on a prosthetic basis

This method is used only if there is a chance of accidental re-displacement (as in habitual dislocation and subluxation).

With this method, special orthodontic constructions are used, which are also called tires.

There are such devices are not removable and removable and they are fastened to the teeth.

Removable tires are more common and there are such varieties:

• Yadrovoy's apparatus;
• the apparatus of Petrosov;
• the apparatus of Burgon-Khodorovich;
• the device Pomerantseva-Urban.

The main function of such constructions-do not let your mouth open wide.

In most cases, the treatment of the displacement of the jaw passes safely and only occasionally there may be slight difficulties in the mobility of the joints.

Rehabilitation period

In principle, with timely assistance and compliance with the recommendations of doctors (the period of immobilization, etc.), the risk of relapse is unlikely. However, in the presence of concomitant diseases, it is possible to develop habitual permanent dislocations and joint stiffness.

After restoring the jaw part, the injured person is given a bandage (chin) for 3-5 days.

In this case, it is recommended to restrict the movement of the jaw, take a soft and semi-liquid food (cereals, soups) and do not open the mouth wide for 1-2 weeks.

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In the treatment of chronic dislocations, the period of wearing the bandage is increased to 2-3 months, so that the joint can grow with a connective tissue.

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As a prophylaxis of jaw bias recommend:

1. Monitor the amplitude of the opening of the mouth (with singing, yawning, eating, cleaning teeth, performing dental and other medical activities).
2. Get rid of the disposable factors.
3. Avoid injuries to the lower jaw.
4. Strictly follow the recommended regimen after treatment.

With the dislocation of the jaw, the main thing is not to panic and do not do it yourself. Such treatment, of course, will not lead to death, but it can provoke severe long-term consequences. And remember: do not delay treatment of jaw displacement.

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How to identify the dislocation of the jaw - correcting and operative treatment of the joint

Dislocation of the jaw - a lesion in which there is a persistent displacement of the temporomandibular joint by the type of slip, while the head of the articular process of the lower jaw goes beyond its physiological position with complete loss of functional mobility. Such a trauma requires specialized assistance, which consists in correct correction.

Subluxation or partial dislocation of the jaw is the same process, but in this case the head retains a partial contact with the articular surface and the possibility of returning to normal position, without the need correction.

Dislocation of the jaw is a common thing when yawning, so it's worth getting enough sleep

The displacement of the temporomandibular joint components occurs in the overwhelming majority of the female sex.

This is explained by the anatomical structure of the joint fossa, which has a lesser depth, as well as the less developed ligamentous apparatus of the joint, than in men, in resulting in a free exit of the head of the process of the lower jaw from the articular bed under the influence of pressure from the external and internal factors.

Such a trauma is not uncommon during the wide withdrawal of the lower jaw down due to yawning, singing, vomiting, attempts to bite off a solid and solid object.

In dental practice, this is possible with a rotator expander or during intubation before surgery.

Dislocation and subluxation can form as a result of traumatization of the joint.

During epileptic seizures, it is possible to exit the articular process due to uncontrolled convulsive contractions.

In elderly people, such a phenomenon is possible in connection with the loss of stability of the ligamentous apparatus, which ensures the fixation of the joint.

Classification of trauma

All dislocations and subluxations of the jaw are classified according to the time of occurrence and the factors that caused them. In the interim, injuries are divided into congenital and acquired. The latter are divided into traumatic and familiar:

1. Traumaticoccur due to mechanical influence on the joint. Depending on the deviation of the process of the mandible in relation to the bone structures, there is anterior, lateral and posterior dislocation / subluxation.
2. Habitual- this repeatedly repeated jaw dislocation, as a result of chronic changes in the structures of the temporomandibular joint. Also there is a back, front and side.

Symmetry of lesions of joints, there are unilateral and bilateral injuries. Dislocations / subluxations are considered acute if the moment of their appearance has passed no more than 10 days. If during this period there has not been a correction, then the process becomes chronic.

In the case when the displacement occurs a change in the integrity of the skin over the joint, rupture of soft tissues, vessels and ligamentous apparatus, then such a dislocation is regarded as complicated, and, conversely, with the preservation of all structures - simple.

As a rule, most often in practice, bilateral bilateral dislocations occur.

Features of the clinical picture

Depending on the type of dislocation of the jaw, clinical symptoms will have their own peculiarities, which also has a favorable effect on the diagnosis of the disease.

1. Anterior dislocation of both joints. The victim is maximally lowered down the jaw with strained muscles. The chin occupies a position with a shift down and back. The movement of the joint is made only in the direction of increasing the angle of opening. In connection with this situation speech is broken, salivation increases with difficulty swallowing. Similar changes are accompanied by pain syndrome. Perhaps the manifestation of edema in the area of ​​the altered joint.
2. Anterior dislocation of one joint. Symptomatically, the pathology will be similar to the previous one, but the clinical difference between these cases is the visual displacement of the facial structures to the intact joint. This makes it possible to distinguish this pathology from a fracture of one of the processes of the lower jaw, as a result of which the face shifts toward the lesion.
3. Posterior dislocation of both joints. The patient's mouth is in a closed position, with the impossibility of opening it. The location of the lower teeth is far behind the front teeth. There is pain in the joints and their swelling. Violation of the speech apparatus with copious salivation. Characteristic forced vertical position, when trying to lie noted choking.
4. Posterior dislocation of one joint. The symptomatology is the same as with bilateral bias, except for the presence of pain only from the side of the lesion, and there is also a displacement of the facial structures to a healthy side.

With all forms of subluxation, the position of the patient's mouth is closed, and occasionally a limited opening of the jaw is possible.

There is also pain symptomatology, which leads to the accumulation of a large amount of saliva.

A distinctive feature of the subluxation is the detection, in palpation, of the process of the mandible on the anterior surface of the temporal bone.

Establishing diagnosis

The diagnosis begins with a general examination, in which it is possible to determine in advance which form of injury the patient has.

The history can also indicate the cause of the injury, giving the opportunity to differentiate the traumatic dislocation / subluxation from the habitual.

After this, the palpation of the location of the bone structures of the joint occurs with subsequent instrumental diagnostic methods, including X-ray and CT-examination. The analysis of the obtained data allows to confirm the presence of pathology, as well as to determine the type and severity of the dislocation.

Methods of correction

Treatment of dislocation involves the direction of the lower jaw in anatomically correct position. There are several methods to do this, but they all provide for local anesthesia to relieve the pain syndrome.

The Method of Hippocrates

To avoid injury, the attending physician wraps his thumbs with a thick towel, thereby protecting them from biting the patient.

The victim himself sits on a chair. After that, the doctor applies thumbs to the far molars of the lower jaw, and the remaining fingers keep it from below.

Slow pressing of the thumbs, the traumatologist presses down, while the other presses to the chin, lifting it up.

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This manipulation helps to relax the muscles of the facial part of the head.

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Then the joint should be moved back and up. At this point, the joint part of the jaw sinks into the articulation gap, producing a specific sound. Upon completion of manipulation, the jaw closes reflexively.

Method Popescu

This method is used for severe pathological dislocations. The patient lies on his back.

Between the distant molars of both jaws a special gauze roll is applied, after which the traumatologist presses on the chin up and back, returning the articular part of the lower jaw back into the joint bed.

Blechman's method

Reception can be performed in one of two ways:

• after groping for the coronal processes in the oral cavity, the doctor presses them with a simultaneous movement down and back, which leads them to return to the joint;
• coronal processes are pressed from the outside and return to the joint fossa in the same manner.

At a risk of relapse of the dislocation, as well as in chronic processes, special tires are used, which perform the role of prosthetics. Their main task is to prevent an overly wide opening of the mouth.

One of these prostheses is the apparatus of Petrosov, whose essence lies in the imposition of crowns on lower and upper jaw, connected by a special limiter, which does not allow the re-opening mouth.

Operative methods of treatment

Also, there are surgical methods of treatment, used for long-lasting dislocations, when the joint structures had time pathologically change, as well as with degenerative joint changes associated with chronic diseases.

Lindemann's method

The task of such an operation is to increase the size of the articular tubercle by splitting it and introducing teflon with fixation by a metal suture.

You can also make a deepening of the joint fossa, which is achieved by moving the articular disc in a vertical position anterior to the fovea. This method allows to ensure reliable fixation of joint structures with the exception of the possibility of relapses.

The Rauer Method

The essence of manipulation is to increase the articular tubercle by using a transplant. In this operation, the costal cartilage is used, which is inserted under the periosteum of the tubercle, which allows to increase its volume.

As an upgrade of the method, an additional reduction of the joint capsule is used, an improvement in fixation by suturing the fascia to the ligamentous apparatus, and also suspending the lower jaw by means of a transplanted tendons.

After the dislocation was corrected, the first time the jaw must be fixed in order to avoid a repeated case of traumatization with relaxed muscles.

Prevention is to be careful when opening the mouth, avoiding wide jaw movement when eating, screaming, singing. If there is a predisposition to dislocation / subluxation, it is necessary to report this to the doctor with dental examinations or preoperative manipulations.

We recommend other articles on the topic

A source: http://dentazone.ru/rot/drugie-bolezni/vyvix-chelyusti.html

Dislocation of the jaw: symptoms and treatment

From injury to the face no one is immune, because in life often there are bruises, falls, direct strokes or just awkward movements (active chewing, deep yawning, etc.).

Diseases of the joints, colds, damaged muscles, deformed bone tissue (osteomyelitis) also increase the chance of dislocation or subluxation of the lower jaw.

Such an ailment should be corrected and healed immediately after the appearance, which will help prevent the development of complications or the wearing of uncomfortable prostheses in the area.

The nature of the problem

In the article we will consider the symptoms of jaw dislocation, the classification of the disease, the causes of the appearance and ways of self-adjustment of the joint.

The jaw joint (diarthrosis) has increased mobility and at the same time reliability, strength, ability to withstand significant loads.

Proceeding from the above, we determine that only the lower jaw can be dislocated, since the upper jaw is immobile in its origin.

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The mandibular is movably connected with the temporal, which allows a person to talk, eat, laugh, cough, yawn, etc.

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Only the lower jaw can be dislocated, since the upper, in its origin,

How does the dislocation occur? The head of the joint jumps out of the capsule, which causes the patient strong discomfort and painful sensations.

After the first precedent, the trauma can be repeated regularly, especially if the person is sick with diseases joints and muscles, osteomyelitis, as well as in the case of natural defects (weak ligaments, small articular capsule).

Subluxation has one significant difference. The head of the joint in this case changes the usual position in the capsule, however, it remains in this or that department. In this case, the patient will be able to set the bone independently.

Causes of subluxation and dislocation of the jaw joint

As a rule, changing the position of the jaw is not so simple, because it takes a lot more strength than the ligaments can bear.

By the way,each person has the strength of ligaments and jointsand sometimes depends on internal and external factors (pathologies of development, acquired diseases, traumatically dangerous sports or professions, etc.).

Some patients, due to an accident or fall, will get rid of only a hematoma and edema in the jaw area. Another is enough yawn or slap to move the position of the joint head.

Why does the displacement of the lower jaw occur:

• mechanical injury due to an accident, a strong blow, a bruise when dropped;
• trauma, obtained during natural processes (yawn, cry, laughter, vomiting, chewing, charging, etc.);
• the patient uses the jaw joint inappropriately (opens the cans and bottles, even the door handles);
• genetic or congenital defects of the joint capsule (the smaller it is, the easier the head pops);
• systemic diseases of bones, joints, ligaments and muscles.

Classification of displacements

Dislocation of the temporomandibular joint: a - anterior; b - rear; в - articular fossa

There are several types collected in different groups.

Depending on the location of the joint head, they are divided into:

• Front (head jumped over the capsule);
• Back (took position behind the capsule);
• lateral (shifted away from the indentation).

Most often we encounter with the front dislocation of the jaw (photo above), so there are a lot of methods of its correction and treatment.

Depending on the side of the displacement, there are:

• bilateral (both joints bones changed position);
• one-sided (position changed the right or left part of the temporal and jawbone).

Symptoms of all varieties are the same, however, the methods of treatment may differ.

Dislocations also differ in degree of difficulty:

• lungs (the joint jumped out of the capsule, easily reentered by the patient himself);
• complex (the process was accompanied by rupture of muscles or ligaments, as well as soft facial tissues).

How is the displacement of the jaw joint manifested?

The general symptomatology for all kinds of ailment is: a painful syndrome and discomfort in the area, a violation of the mobility of the jaw and the amplitude of its movement, increased salivation, a strong swelling in the area.

Two-sided anterior dislocation is additionally accompanied by the following symptoms:

• patient can not close his jaw, keeps his mouth in a slightly open position;
• the area around the ear lobe swells, severe pain is observed;
• the patient can not speak clearly or even talk at all.

If it is a one-sided shift, then all the symptomatology concerns only one side of the head.

Two-sided anterior dislocation

Two-sided posterior dislocation of the lower jaw is characterized by symptoms:

• the zone under the ear lobes swells and hurts;
• the mouth remains in the closed position without the possibility of even slightly opening;
• the dentition goes further in the direction of the throat;
• a person may experience suffocation in asleep;
• the patient is not able to pronounce the words normally.

The lateral dislocation is characterized by the following symptoms:

• The jaw has shifted to the left or right side without the possibility of an independent return to the natural position;
• the side of displacement swells and hurts;
• patient hardly speaks words, speech is indistinct.

The subluxation has similar symptoms, however, the jaw can remain partially mobile, only during the change of position the patient will hear a click. Almost always the oral cavity remains closed (except for anterior subluxation). There is also increased salivation.

How to cope with ailment

Basically, the treatment is based on the adjustment of the joint to the starting position. There is a lot of progressive methods for this, some of them the patient can try on his own.

The Method of Hippocrates

The doctor conducts preliminary diagnosis and prescribes an x-ray of the area. The referral will be carried out by a qualified specialist - orthopedist, orthodontist or traumatologist. Often, general or local anesthesia is used: activities cause acute pain.

So, the doctor wraps the thumbs of his hands with a cloth (napkins, bandage, towel, etc.). The patient is sitting on a chair.

The doctor places his thumbs on the location of the molars, while the other firmly and reliably grips the lower jaw.

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Further, pressure is applied to the bone with the thumbs, after which the rest are placed on the chin and pull it upwards.

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Direction of anterior dislocation of the temporomandibular joint (Hippocrates method)

This helps to relax the masticatory muscles. Then the doctor moves the jaw back (towards the throat), and then immediately upwards, after which the head becomes a capsule with a characteristic click and jaw closure.

Further for 7-9 days the patient is fixed a special bandage. At the same time, he is forbidden to open his mouth wide for 2-3 weeks.

To do this, you must follow a special diet, avoid active communication and situations where you can get an injury area.

The Blechman-Gershuni method

Includes 2 options.

• Option 1. The doctor determines the coronary processes in the oral cavity of the patient, which changed the position. Then he presses them down and quickly takes them back, adjusting the joint in a natural position.
• Option 2. Less painful. The same processes should be found from the outside of the jaw (located in the region of the brow of the cheekbone). Then the doctor grabs them with his fingers and performs movements similar to the first option. Many people ask how to insert the jaw into the place itself.You can try the second option, but it is better to teach him a family member. It takes a few seconds to recover.

Method Popescu

As a rule, it is resorted to in the case of a long-standing forward bias, when other methods are ineffective or can cause harm. It is necessary to use general or local anesthesia.

The patient occupies a horizontal position. The doctor places the tissue rolls (diameter more, cm) in the area of ​​the teeth of both jaws, then presses the chin up and back. The joint becomes at the usual place, the jaw closes, and the teeth are not damaged because of the rollers.

Prosthesis is also used in cases when dislocations have acquired a chronic form or there is a risk that the injury will recur.

These attachments fix the joint, preventing the mouth from opening wide.

If the methods of correction do not help, perhaps, surgical intervention followed by physiotherapy and the wearing of special prostheses

Remember, to avoid this serious injury and possible subsequent complications (chronic displacement), you should abandon traumatic sports, wrestling, extreme pastime. The dislocation of the jaw causes considerable inconvenience to the patient: it interferes with working, communicating, eating, expressing emotions. It is much easier to try to avoid such a trauma than to try to correct the mistake.

A source: http://VashyZuby.ru/drugie-zabolevaniya/vyvix-chelyusti-simptomy.html