OO is a 45 year old male shoe maker. He\nwas single. He presented with a one week history of\ninability to close the mouth following a fall from a moving bus. There was associated loss of\nconsciousness which lasted about 10 minutes. He was\npreviously treated for Tuberculosis 15 years prior to\npresentation and claimed to have completed the\nprescribed regimen. No other comorbid condition\nwas noted. On general examination, we saw middle-aged\nman who walked with a limp. There were facial\nbruises over the left supraorbital ridge and right\nzygomatic area, tip of the nose and right side of the\nupper lip, sutured laceration on right foot, but no\nobvious facial asymmetry nor bony discontinuity was\ndetected. Intraorally, there was gagging of occlusion\nposteriorly, and retained roots of 12 and 22. No other\nsignificant intraoral finding was detected. Radiological\nexamination revealed anterior dislocation of the\ntemporomandibular joint bilaterally. The patient had\nHippocrates maneuver for repositioning the condyle\nwhich was successful after four (4) attempts. Analgesia\nwas also administered and the patient discharged home.\nHowever, two days later he returned with a recurrent\nTMJ dislocation following yawning. The dislocation\nwas reduced using Hippocrates maneuver modified\nwith administration of diazepam. Barrel bandage was\napplied to limit joint mobility. The patient was seen\ntwo days later with no evidence of dislocation.
NP was a 60-year-old housewife who\npresented with a three hour history of inability to close\nthe mouth after yawning. There was associated pain\nand discomfort in the preauricular area bilaterally. She\nhad a similar incident four (4) months earlier. No\nprevious history of trauma. She is a known\nhypertensive on moduretic. A diagnosis of bilateral\nanterior TMJ dislocation was made. She had a\nsuccessful treatment using the extra-oral technique after\nfailed Hippocrates manouvre attempts. She was\nsubsequently immobilized with the barrel bandage