Treatment of chronic mandibular dislocations by bone plates: Two case reports

Background: Various surgical procedures have been used to limit mandibular opening in patients with recurrent dislocations of the temporomandibular joint (TMJ). These include intracapsular injection of sclerosing agents and tethering of the mandible. Other methods include obstruction of the condylar translation by downfracturing the zygomatic arch or by bone graft augmentation of the tuberculum and creating a mechanical impediment using Vitallium mesh or a stainless steel pin. Material: In this paper, two patients are described in whom the range of condylar movement was restricted by a bone plate attached to the lateral surface of the zygomatic arch. One arm of the plate was extended medially just below the articular eminence. One patient had a hypermobile joint in combination with mitral valve prolapse, and the other patient suffered mental retardation. The surgical technique is described in detail. Result: Six months postoperatively, TMJ function was unimpeded and there was no recurrence of condylar dislocation. (C) 2003 European Association for Cranio-Maxillofacial Surgery.