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

Background and Objectives: Long-standing or protracted temporomandibular joint dislocation refers to a condition that persists for more than 1 month without reduction. To elucidate the clinical characteristics and treatment results of this condition, this comprehensive review analyzed the available data. Materials and Methods: Studies were assessed using electronic medical databases and manual searches from their inception to 31 December 2024. Results: Overall, 229 cases (139 women and 81 men; mean age, 52.3 years) from 113 reports were assessed. The proportion of patients with bilateral and unilateral dislocations was 74.7% and 8.7%, respectively. The mean duration since dislocation was 11.9 months. Closed and open reductions were possible in 49 (21.4%) and 175 patients (76.4%), respectively. The mean dislocation duration was significantly (p = 0.001) shorter in patients who underwent closed reduction (4.9 months) than in those who underwent open reduction (14.8 months). Conclusions: Clinically, it is crucial to diagnose and treat this condition early to prevent it from becoming chronic. However, for cases of long-standing dislocations due to other more serious diseases, conservative treatments such as manual reduction and continuous elastic traction should be attempted first. If reduction fails, surgical treatment should be performed as an alternative.