Background: Acute mandibular dislocation is a very painful condition that causes severe functional limitations. Manual reduction, with or without pharmacological assistance, is the treatment of choice and should be performed as early as possible. In rare situations, mandibular dislocation may not be perceived by the patient and remains undiagnosed or misdiagnosed for a long period, which develops a long-standing condition. Morphological changes of the joint and associated structures will prevent successful manual reduction even with the patient under general anesthesia. This article aimed to share the author’s experience in management of two unique cases of protracted mandibular dislocation.
Patients and methods: The present article reported two patients who have long-standing temporomandibular joint dislocation due to trauma, which could not be treated conservatively and must be treated surgically. One patient had a very long-standing dislocation for 14 years, which was treated by bilateral sagittal split osteotomy, and the other one had a unilateral protracted temporomandibular joint dislocation for 6 months, which was treated with condylotomy and condylar refixation in place after returning her occlusion back to its normal position.
Results: After 1-year follow-up, both patients were doing well from functional and esthetic points of view, with complete satisfaction with the treatment they received.
Conclusion: The cases of long-standing dislocation need to be defined according to the time and cause of dislocation, and more opinions are required to form practicable guidelines for management of each case individually.