TMJ Dislocation

hello guys this is dr. mama Patel from Team MDS conquered in this video I'll be talking about TMJ disorder TMJ dislocation a dislocation of the entire disk condyle complex beyond the articular eminence combined with inability to return passively into the fossa but a subluxation and overextension of the disk kondal complex beyond the articular eminence but it has ability to return passively into the fossa the basic difference between subluxation and dislocation is in subluxation the condyle has the ability to return passively into the fossa but enjoying dislocation the condyle is unable to return passively into the falsi once it is out of the forceout so basically the tissues which are elastic like the capsules ligament and structures which are holding the disk in position like little difficult anteriorly in the retro tusculum eine posteriorly their elasticity has been lost and the tissue has become relaxed allowing the moment of the condyle out of the fossa so etiology can be any intrinsic trauma like overextension injury during yawning vomiting wide biting Chasseur disorders or any extremes of trauma such as flexion extension injury to the mandible or while incubation or while endoscopy or during extraction or forceful hyperextension any connective tissue disorders like hypermobility syndrome earlier analyst syndrome Marfan syndrome can also cause dislocation other causes include internal derangement dis synchronous muscle function control it will intra articular obstruction or any occlusal discrepancy some people may have habitual dislocation as well drugs like phenothiazine is known to induce DNA dislocation classification of TMJ dislocation placed on a Kim manatee it shows the relationship of the condyle with the articular eminence in type 1 the head of the condyle is directly below the tip of the articular eminence in type 2 the head of the condyle is in front of the tip of the articular eminence in type three the head of the condyle is high up in front of the base of the articular eminence so you this location can be unilateral by lectures clinical features of unilateral dislocation includes mandibles ones away from the side of this location they will be open bite on the contralateral side there will be listing hollow in front of the triggers on the ipsilateral side and the occlusion is protocell bilateral dislocation you have pain inability to close mouth there will be tense masticatory muscles difficulty with speech excessive salivation a protruding chin and and there open bite and distant hello in front of the tethers bilaterally sometimes the later pole of the condyle produces characteristic for true balance and here too and below the articular eminence this is a 3d CBT City showing the dislocation of the condi this is the articular eminence this is the glenoid fossa the condyle has mode out of the four sound here in this picture this is the glenoid fossa this is the articular eminence the condyle has more completely out of the force and here to the articular eminence so basically the elasticity of the tissue has been lost and the tissue has become relaxed which holds the disk in position role of the treatment is to restrict the mandibular translation to remove any obstacle that's preventing the mandibular dislocation in locking and here to the articular eminence in this picture this is the normal position of the condyle in the glenoid fossa this is the articular eminence the condyle moves out of the fossa beyond the articular eminence and really and gets logged here due to the laxity of the tissue which is holding the disc in its position in case of acute dislocation and it was immediate attention for the relief of pain in anxiety to minimize damage to the joint structure reduction and immobilization for four weeks will have allow the damaged ligament capsules and this to heal manual reduction of the join can be done with two methods Dingman in-network method and uranus method in this Dingman and network method the operated stands in front of the patient and the thumbs are plays by literally onto the mandibular molars and the mandible is pushed downwards and backwards into the foursome in this the operator stands behind the patient and one hand is placed on the condylar head and the other hand goes on the lower surface of the mandible holding the body of the mandible pushing it downward and backward into the fossa in the maxillary fixation can be done with elastics or Martin's bandage what is the purpose of inter maxilla fixation if any damage or injury to the elastic tissue which is holding the articular disc in place has been occurred immobilization causes it to heal immobilization allows it to heal ultrasound therapy it is an another method by which we can promote collagen synthesis by human fibroblasts therefore this may help in stabilizing the joint our intra articular injections of plus platelet-rich plasma or biologically active molecules or any drugs like corticosteroids can induce fibrosis inside the joint chemicals capsulorrhaphy bicycles in the year 1947 the principle was to induce fibrosis and restrict the joint moment he used three percent sodium dodecyl sulfate sodium sai late immersion in oil or sodium moderate surgical treatment would include plication of the capsule in ligament ligation is nothing but the tissue has been lags so it has become loose the loose tissue some part of tissue we will be taking out ends so sitting it back into the place to increase the stiffness of the joint me reg amin ectomy in 1951 Malaga's proposed eminem again cause reaction in the TMZ dislocation the here in the specificity the articular eminence is cut and removed so that when the condyle moves out of the fore side it can passively return into the for some little pterygoid my ultimate is nothing but freeing of the disc with the little kitty garden much muscle attachment anteriorly which was given by boven this is Daughtery zygomatic arch osteotomy mayor's grafting technique on the eminence which was given in the year 1933 here the zygomatic arch is intentionally fractured and grafted to the eminence to provide a mechanical obstruction obstruction so that the condyle does not move in front of the articular eminence so this is about TMJ distillation I thank team MDS conquer for giving me opportunity to speak on TMJ dislocation thank you everyone