Therapy of recurrent fixed anterior TMJ dislocation with mini-plates in an aged patient with other ailments. A case report | Die Therapie der rezidivierenden, fixierten anterioren Kieferluxation mittels einer T-förmigen Miniplatte bei einer älteren polymorbiden Patientin--ein Fallbericht]

Abstract

Unilateral or bilateral dislocation of the TMJ is frequent. Usually it can be treated by the method described by Hippocrates. If conservative treatment (splint therapy, biofeedback, etc.) does not succeed related to recurrent fixed TMJ-dislocation, surgical therapy strategies become necessary. Above all mentally retarded or patients with neuromuscular disorders may necessitate surgical treatment. The two surgical main procedures are: 1. Removal of mechanical obstacles by reduction of the eminentia. 2. Creation of a mechanical obstacle towards the anterior condylar translation. The here presented case shows the treatment of a reccurent, fixed anterior TMJ-dislocation using a miniplate which enables a absolut heightening of the articular tubercle in a 76 years old lady with Morbus Alzheimer and Parkinson. Due to the high incidence of plate fractures, this well discribed therapy, known as miniplate eminoplasty, can not be considered as the treatment of choice for mandibular dislocation. It can be indicated in non-compliant patients or in patients with neuromuscular disorders or in the combination of both as in our case.