Surgical treatment of chronic temporomandibular 5 joint dislocation : A case report

12 Abstract 13 Introduction Chronic dislocation of temporomandibular 14 joint is usually treated with conservative approaches, but 15 in some cases, surgery is needed to avoid recurrencies. The 16 present paper described a case report of a bilateral 17 intervention for articular tubercle height augmentation by 18 means of calvaria bone grafts. 19 Materials and Methods A 32-year-old woman attended the 20 Department of Maxillofacial Surgery, University of Padova, 21 Italy, in January 2007 seeking treatment for a bilateral 22 recurrent temporomandibular joint dislocation. She was 23 treated with a surgical procedure providing an antero24 posterior osteotomy of the caudal portion of the articular 25 eminence and the insertion of a calvaria bone graft, 26 preserving the periosteum of the borders of the osteotomic 27 beach. The newly remodeled articular eminence has an 28 increased height, thus representing a barrier to condylar 29 dislocation out of the glenoid fossa. No ostheosynthesis 30 fixation was provided, and physiotherapic rehabilitation 31 was started in the immediate postoperative phases to help 32 the patient gain a good jaw function as soon as possible. 33 Results Such a technique showed to be effective, as during 34 an 8-month follow-up span, the patient referred no recurren35 cies of joint dislocation. Jaw motion parameters maintained 36 good over the entire follow-up period, and radiological 37 assessments showed no signs of bone grafts reabsorption. 38 Conclusions The technique described in the present case 39 report has some potential advantages over other surgical 40 approaches to the treatment of recurrent temporomandibular 41 joint dislocation that need to be assessed with future studies.