28 year old female student was in her usual\nstate of health until a week earlier when she was unable\nto close her mouth after brushing her teeth. There was\nassociated pain in the preauricular area bilaterally. She\nwas a known RVD patient awaiting treatment\ncommencement of HAART but had no other\ncomorbid conditions. On general examination, the\npatient was frail, and weak, with a prognathic mandible.\nPreauricular depression and tenderness were present\nbilaterally. Intraorally, there was an anterior open bite,\nposterior gagging of occlusion, oral thrush. Patient\nwas diagnosed as having bilateral TMJ dislocation and\nwas successfully treated with Hippocratic manouvre\nunder diazepam and PCM after the second attempt,\nwith restoration of full TMJ functions.
OS, a 65-year-old female trader presented\nwith a one year history of clicking sounds in the right\ntemporomandibular joint area on mastication. There\nwas no history of trauma, pain, swelling or any other\nsymptoms. Background medical history revealed that\nshe was a known hypertensive on medications. On\nexamination, it was discovered that the patient had\nbilateral TMJ clicking sounds on mandibular excursion.\nThere were no areas of swelling/depression or\ntenderness. Plain X-ray (TMJ views) showed anterior\ndislocation of the right mandibular condyle on opening.\nA diagnosis of chronic recurrent right TMJ dislocation\nwas made. She was treated with intraarticular injection\nof triamsinolone 40mg weekly for six weeks alongside\nphysiotherapy. There was improvement of symptoms\nand she did not present for follow up or with\nreoccurrence.