Clinical Paper
TMJ Disorders
Autologous blood injection for the treatment of recurrent mandibular dislocation

https://doi.org/10.1016/j.ijom.2015.05.004Get rights and content

Abstract

The purpose of the present study was to evaluate the effectiveness of autologous blood injection in the treatment of recurrent temporomandibular joint dislocation. Eleven patients diagnosed with recurrent dislocation of the joint that could not be self-reduced, received bilateral injections of autologous blood in the superior joint compartment and pericapsular region. During a follow-up period ranging from 24 to 35 months (average 29.6 months), eight patients (72.7%) did not show new episodes of dislocation. The most advocated treatment for recurrent dislocation is eminectomy, which involves a skin incision, with the risk of damaging the facial nerve, requires general anaesthesia, and presents an average success rate of 85% according to the literature. Autologous blood injection is a simple, rapid, minimally invasive, and cost-effective technique, with a low possibility of complications, and is a feasible alternative treatment before surgical intervention.

Section snippets

Patients

This clinical trial included patients treated in the oral and maxillofacial centre of the study hospital between the years 2010 and 2013. During the initial screening, 23 patients were selected based on clinical and imaging examinations. The clinical examination assessed the maximum incisal opening (MIO), number of episodes of dislocation, necessity of professional assistance for reduction, and vertical dimension of the lower facial third. Panoramic and TMJ radiography, in the closed and open

Results

Of the 23 patients initially selected, 10 were excluded since they were able to self-reduce the condylar dislocation and two were excluded as they presented fewer than three episodes in a 6-month period. The final sample comprised 11 patients with chronic recurrent TMJ dislocation; eight were women and three were men, and their average age was 27.8 years (range 15–60 years). The average duration of symptoms was 63.9 months, ranging from 4 months to 16 years. The number of dislocations prior to

Discussion

Historically, the gold standard treatment for recurrent TMJ dislocation is eminectomy, with success rates higher than 85%.17, 18, 19, 20 Although this technique is favourable in terms of the success rate, it is an invasive procedure, requiring a hospital stay and skin incision, with an increased risk of facial nerve injury and unaesthetic scars. Even if frequently performed with rotatory instruments, irregular areas and bone spicules may be left behind inadvertently and lead to crepitation or

Funding

No sources of funding.

Competing interests

The authors have no conflicts of interest to declare.

Ethical approval

The current research was approved by the ethics committee for research of Pedro Ernesto University Hospital, Rio de Janeiro, Brazil (reference number 21473, signed by Wille Oigman).

Patient consent

All patients signed an informed consent agreement. This study followed the Declaration of Helsinki on medical protocol and ethics.

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