Comparison of different approaches to the reduction of anterior temporomandibular joint dislocation: a randomized clinical trial

Abstract

This randomized clinical trial was designed to compare three different reduction methods for anterior temporomandibular joint (TMJ) dislocation. The three methods evaluated were the conventional method, wrist pivot method, and extraoral method. The study sample comprised 90 consecutive patients suffering from anterior dislocation of the TMJ, who were allocated randomly to one of the three groups. This study found success rates of 86.7% for the conventional method, 96.7% for the wrist pivot method, and 66.7% for the extraoral method. The extraoral method was more difficult for the physician and the patient than the other two methods. For the patients, the wrist pivot method was easier than the other methods. For the doctors, the extraoral method was significantly more difficult than the other methods. In conclusion, due to the absence of a biting risk with the extraoral method and the lack of a significant difference in success between this method and the conventional method, the extraoral method could be considered the appropriate first-line treatment where there is a risk of the patient biting the surgeon's hand. Given the overall benefits of the wrist pivot method, this method could be considered the first-line and gold standard treatment modality in other cases.

Keywords: temporomandibular joint; temporomandibular joint dislocation; temporomandibular joint reduction.