Dislocation of the mandibular joint occupies a significant place in the structure of the pathology of the maxillofacial region. Most often able-bodied persons and pensioners suffer, women more often than men due to anatomical features. The movable lower jaw, the fixed upper jaw and the chewing muscles that interact with them make up the jaw-chewing apparatus.
Dislocation of the temporomandibular joint is a pathological condition in which articular surfaces do not match. This is due to the fact that the head of the lower jaw leaves the articular cavity of the temporal bone. In this article, we will consider the classification of dislocations and see how the jaw is adjusted.
Jaw dislocation classification
Depending on the anatomical location of the dislocated head relative to the cavity, the dislocation happens:
1. The front.
2. The back.
Depending on the degree to which articular surfaces are displaced, dislocation of the lower jaw can be:
1. Full - with a complete mismatch.
2. Subluxation - with partial mismatch of the articular surfaces.
Localization makes a dislocation of the lower jaw:
1. Unilateral (right-handed or left-handed).
2. Bilateral - this type is more common.
Anamnestic sign and duration of existence makes a dislocation:
1. First arising.
2. To the elderly - if primary dislocation is not treated for 1-2 or more weeks.
3. A habitual dislocation of the jaw - it occurs frequently (maybe even several times a day), is adjusted on its own.
Depending on the complications, a dislocation can be:
1. Simple or uncomplicated.
2. Complicated (with rupture of muscles, ligaments, skin, nerves, blood vessels, fracture of the jaw).
How to adjust the jaw with various dislocations? This question interests many.
Causes of occurrence
Dislocations occur due to the following traumatic injuries:
1. Bruises and blows to the lower jaw with objects or during a fall.
2. A sharp strong movement of the jaw while eating, chewing solid food.
3. Yawning or strong opening of the mouth.
In addition, injury may occur due to the following non-traumatic injuries:
- Bad habits that can occur when large objects are placed in the mouth or the jaw is not used for its intended purpose (people open bottles, cans, crack nuts with their mouths).
- The presence of background diseases that weaken the ligamentous-articular apparatus (diabetes mellitus, joint osteoarthritis, rheumatic and gouty lesions, lower jaw osteomyelitis, osteoporosis, age-related changes).
The treatment of these dislocations is performed by maxillofacial surgery in Moscow.
Clinical signs and diagnostic methods
When a dislocation occurs, a click is heard in the area of the jaw joint, which is accompanied by rather severe pain. After this, the mouth no longer closes due to pain or mechanical obstruction.
Depending on which dislocation occurred (posterior or anterior), the jaw extends either forward or sinks backward. If it is one-sided, then the jaw looks skewed. All this is accompanied by excessive salivation, since the swallowing process is impaired.
Human speech becomes slurred or impossible. As a rule, these symptoms appear during the first dislocation of the jaw.
A certain time should pass, and if the dislocation is not corrected, then it will become chronic. Abnormal scar tissue grows on the joints of the jaw, atrophy of the ligaments and muscles occurs. As a result of the reduction, it becomes impossible to keep the joint in a physiological position.
About subluxation
Subluxation of the mandibular joint deserves attention. As a rule, it is not diagnosed for a long time due to the absence of obvious symptoms. Time is lost, dysfunction of the lower jaw occurs. And this complicates the possibility of reduction of the lower jaw in a standard way.
Long-standing or primary dislocations often provoke the occurrence of habitual dislocations. The capsule of the joint and ligaments is greatly stretched, the stability of the joint is lost. The head constantly pops out of the articular surface during any movement with the jaw.
The main diagnostic method is radiography of the lower jaw and joint. But it may not be informative. Then an ultrasound scan is performed, computed or magnetic resonance imaging.
It is better to treat such an injury to the maxillofacial department of the district hospital.
Conservative treatment
Treatment methods can be divided into operational and conservative. It depends on what kind of dislocation, and whether it can be eliminated in a gentle way.
The first stage is conservative treatment, which is used as the first stage for all types of dislocations. The displaced head of the joint is set into the articular cavity.
How to adjust the jaw? About it further.
Stages of reduction of jaw dislocation
The patient needs to be seated on a chair with a hard back and headrest. The head and body must be pressed to the support, the legs are pressed to the floor or stand. That is, a complete fixation of the body in a strictly defined position is needed.
Jaw joints are anesthetized. Infiltrate the affected surface with novocaine or lidocaine. With full anesthesia, muscle relaxation and better reduction are provided. There are cases of reduction without the use of anesthesia.
The doctor wraps his thumbs with bandage or gauze. This must be done so as not to get injured on the patient’s teeth. Then they are placed in the oral cavity on the painters of the lower jaw, with other fingers you need to grasp the lower jaw and its angle.
Direct reduction is performed - the jaw moves down and back, then moves forward. At the last stage, it rises up and back. The dislocation in this way is corrected, and it does not matter what type it is.
The head of the jaw makes a circular movement around the articular cavity. After the dislocation has been corrected, the jaw needs to be fixed for 14 days, sometimes longer. For this purpose, apply a tire overlay or conventional bandage dressing. Mouth cannot be opened strongly, therefore food should not be solid.
Joint function will recover better if all recommendations are followed. Old or habitual dislocations are fixed after reduction in a different way. This will require a special device that will help fix the jaw in a certain position. Fixation is needed for fouling of the joint with connective tissue.
Surgical treatment
The best operations of this kind are performed by maxillofacial surgery in Moscow.
This type of jaw dislocation therapy is used only for old or familiar forms. And also in those cases when traditional methods of reduction do not help. With the help of surgery, new ligaments are created or old ones are restored. They will ensure that the mandibular joint remains stable. The dislocation is also corrected, the jaw is fixed.
First aid for dislocation
So, a person has a jaw dislocation. How to fix it yourself? It must be remembered that the procedure is very painful, and not everyone can do it. Therefore, it is better to trust the hands of a professional.
But, first of all, the patient must be given first or first aid. The victim needs to calm down and try not to make any movements with his jaw.
With the help of improvised means, the jaw is fixed so that the process of transportation to a medical institution is painless. If necessary and possible, a person can be helped to reduce pain. To do this, you can take drugs such as "Paracetamol", "Ketorol", "Analgin." No need to try to straighten the jaw yourself.
We examined in detail how to adjust the jaw. This process is quite responsible, painful. Therefore, you must contact the specialized maxillofacial department of the hospital if you suspect any type of dislocation. Pulling this also should not be, since serious complications may develop.