4 Reduction Techniques of Anterior Mandible Dislocation
Classic intra-oral reduction
- Place thumbs over the patient’s inferior molars
- Apply downward force and then guide the mandible posteriorly
Wrist Pivot Method
- Place thumbs at the chin
- Place other fingers on the inferior molars
- Pivot your wrists
Syringe
- Place a syringe between the molars of one side
- Ask patient to bite down and roll the syringe back and forth
- Once one side is reduced, you can repeat the same maneuver on the other side
Extra-oral reduction (Coronoid process pressure)
- When the mandible is dislocated, the coronoid process is palpable extra-orally, but not palpable when there is no dislocation.
- Apply thumb pressure posteriorly on the cheek over the coronoid process and rest the other fingers on the mandible for stabilization.
- With your other hand, apply pulling/anterior force over the mandibular angle to facility contralateral TMJ reduction
- 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/