Glenotemporal osteotomy as a definitive treatment for recurrent dislocation of the jaw.

ABSTRACT

Chronic Recurrent Dislocation of the jaw (CRD) is a relatively frequent occurrence, with a multifactorial aetiology. Both conservative and surgical treatments have been applied to this entity. This paper seeks to review the results of surgical treatment applied according to Norman's technique (1984), with certain modifications, applied to CRD. Ten patients were treated by glenotemporal osteotomy and interposition of bone grafts, (four cranial bone grafts and six iliac crest grafts). Previously, all of the patients had suffered numerous episodes, requiring hospital care on more than one occasion. Nine of the patients were female. All of the patients underwent clinical exploration and pre- and postoperative radiological study. Nuclear Magnetic Resonance (NMR) imaging was used in combination with tomography in the preoperative period to evaluate the state of the joint. In the postoperative period, tomography was used as the radiological investigation to carry out regular follow-ups. The patients were followed for between 5 and 51 months. The elements used in osteosynthesis were either wire, screws or nothing. None of the patients complained of any episode of RCD in the postoperative period. Oral opening, which could not be measured in the preoperative period, ranged between 28 and 38mm in the postoperative period. One of the patients operated on still suffered articular pain on attempting this function. In the postoperative period, radiology revealed different degrees of bone resorption in the cases of iliac crest bone grafts, yet this did not affect the clinical result of the operation.