A New Approach for Reduction of Anterior Mandibular Dislocation: Semi-Sitting Technique

Editorial

I read the published article by Heidari [1] with title: “The new technique for reduction of bilateral mandibular dislocation” with great interest. In this study has been explained a new technique for reduction of bilateral anterior mandibular dislocation. This technique was performed on one patient that ordinary approach failed. Temporomandibular joint (TMJ) dislocation is an uncommon presentation to the emergency department (ED) and may occur in up to 5% of the population during their lifetime [2]. Anterior dislocation is the most common type seen in clinical practice [3]. In the traditional method described for reduction of bilateral TMJ dislocation, the operator stands in front of the patient and inducts intraoral bilateral inferior-posterior downward force on the patient's molar occlusal surfaces [4,5]. In this new technique (semi-sitting approach), the patient Placed on a bed in semi-sitting position and the operator stands behind the patient. Then, the physician places both thumbs bilaterally posterior to the patient's last molar teeth, on the retro-molar gum along the ramus of mandible. Then, bilateral inferior-anterior downward force in this position was given [1]. The benefits of this technique are that the bilateral inferior-anterior downward force provides a levering action on the mandible, which reduction with lower force than traditional methods accomplished, and that it increases the chance of successful reduction of bilateral mandibular dislocations. In addition, working with this technique is easier than conventional methods for operators. It looks that will be done for unilateral or posterior mandibular dislocation but however, further studies need to be done in this case.

References

1. Heidari SF. The new technique for reduction of bilateral mandibular dislocation. Am J Emerg Med. 2015; 33: 1327.
2. Luz JG, Oliveira NG. Incidence of temporomandibular joint disorders in patients seen at a hospital emergency room. J Oral Rehabil. 1994; 21: 349– 351.
3. Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation: systematic review of literature and a proposed new classification of temporomandibular joint dislocation. Head Face Med. 2011; 7: 10.
4. Luyk NH, Larsen PE. The diagnosis and treatment of the dislocated mandible. Am J Emerg Med. 1989; 7: 329–335.
5. Chan T, Harrigan R, Ufberg J, Vilke G. Mandibular reduction. J Emerg Med. 2008; 34: 435–440.