Prospective Comparison of the Traditional Method with a Extraoral Method for Temporomandibular Joint Reduction

Ahn,  Jung Hwan; Jung,  Ji Yoon; Kim,  Ki Woon; Jung,  Yoon Seok; Min,  Young Gi

J Korean Soc Emerg Med > Volume 16(6); 2005 > Article

Randomized Controlled Trial

Journal of The Korean Society of Emergency Medicine 2005;16(6): 635-639.

Prospective Comparison of the Traditional Method with a Extraoral Method for Temporomandibular Joint Reduction

Jung Hwan Ahn, Ji Yoon Jung, Ki Woon Kim, Yoon Seok Jung, Young Gi Min

Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea. youngmd@ajou.ac.kr

ABSTRACT

PURPOSE:
The usual technique of temporomandibular joint (TMJ) reduction, recommended by most emergency medicine textbooks, consists of downward forces applied to the mandible. However, it has been the authors' experience that conscious sedation and significant force is required to achieve reduction. For that reason, we designed a new method of TMJ reduction. The purpose of our study is to introduce the new method of TMJ reduction and to compare the traditional method with the new method.
METHODS:
We performed a prospective, randomized trial with 52 patients who were diagnosed as having a TMJ dislocation. The patients were divided into two groups: the group treated with the traditional method (25 cases) and treated with the new method (27cases). Patients with histories of trauma or inflammatory signs were excluded from this study. The new method is an extraoral approach in which the operator applies the coronoid process on the face in the posteroinferior direction.
RESULTS:
Age, sex, and history of TMJ dislocation showed no statistical differences between the two groups. Reduction of the TMJ dislocation was achieved in 15 (60.0%) of the traditional method group and in 25 (92.6%) of the new method group (p=0.005). The means of the reduction time were 11.8+/-6.2 sec in the traditional method group and 6.6 +/- 3.3 sec in the new method group (p=0.007).
CONCLUSION:
The new method was an effective treatment for TMJ dislocation without any sedations. I had a higher success rate and a shorter reduction time than traditional method.

Key words: Temporomandibular joint, Mandible, Dislocation