4 Reduction Techniques of Anterior Mandible Dislocation

Classic intra-oral reduction 

  1. Place thumbs over the patient’s inferior molars
  2. Apply downward force and then guide the mandible posteriorly

Wrist Pivot Method

  1. Place thumbs at the chin
  2. Place other fingers on the inferior molars
  3. Pivot your wrists

Syringe

  1. Place a syringe between the molars of one side
  2. Ask patient to bite down and roll the syringe back and forth
  3. Once one side is reduced, you can repeat the same maneuver on the other side

Extra-oral reduction  (Coronoid process pressure)

  1. When the mandible is dislocated, the coronoid process is palpable extra-orally, but not palpable when there is no dislocation.
  2. Apply thumb pressure posteriorly on the cheek over the coronoid process and rest the other fingers on the mandible for stabilization.
  3. With your other hand, apply pulling/anterior force over the mandibular angle to facility contralateral TMJ reduction
  4. Once one side is reduced, you can repeat the same maneuver on the other side

Sources:

Chen, Y.C., et al. A safe and effective way for reduction of temporomandibular joint dislocation. Annals of plastic surgery 2007;58(1):105-108.

Gorchynski, J., Karabidian, E. and Sanchez, M. The “syringe” technique: a hands-free approach for the reduction of acute nontraumatic temporomandibular dislocations in the emergency department. The Journal of emergency medicine 2014;47(6):676-681.

Zweifel , D.F., Pietramaggiori , G. and Broome , M. Repositioning Dislocated Temporomandibular Joints. New England Journal of Medicine 2014;370(6):e9.

Blogs:
https:// www.aliem.com/2016/01/trick-of-the-trade-extra-oral-technique-for-reduction-of-anterior-mandible-dislocation/
http:// sinaiem.org/the-syringe-technique-for-tmj-dislocations/