Long-Standing Temporomandibular Joint Dislocation: A Comprehensive Review and Proposal of a Treatment Algorithm

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Temporomandibular Joint Disorders

Background:

• Long-standing temporomandibular joint (TMJ) dislocation is defined as a condition persisting over one month without reduction.
• This review aims to clarify the clinical features and treatment outcomes of protracted TMJ dislocations.

Purpose of the Study:

• To analyze the clinical characteristics of long-standing temporomandibular joint dislocations.
• To evaluate the treatment results for chronic TMJ dislocations.

Main Methods:

• A comprehensive literature review was conducted using electronic medical databases and manual searches.
• Data from 229 cases reported in 113 studies up to December 31, 2024, were analyzed.

Main Results:

• The review included 229 patients (mean age 52.3 years; 74.7% bilateral dislocations).
• Mean duration of dislocation was 11.9 months.
• Closed reduction was successful in 21.4% of cases (mean duration 4.9 months), while open reduction was performed in 76.4% (mean duration 14.8 months), with a significant difference (p=0.001).

Conclusions:

• Early diagnosis and intervention are vital to prevent temporomandibular joint dislocations from becoming chronic.
• For persistent dislocations, conservative methods like manual reduction and elastic traction should be prioritized.
• Surgical intervention is considered if conservative treatments fail to achieve reduction.