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.
OO was a 40-year-old female fashion\ndesigner who presented with a 1 day history of inability\nto close her mouth following a fall during an epileptic\nfit during which she hit her face on the floor. This was\nthe seventh episode, the first episode having occurred\n13 years prior to presentation. She is known epileptic\nof twenty eight years on Epanutin and Phenobarbitone.\nOn examination, patient had obvious facial asymmetry,\nwith flattening of the left side of the face, elongation\nof the face and a depressed hollow in the preauricular\nareas bilaterally. There was also enamel fracture of 11.\nDiagnosis made was that of bilateral anterior TMJ\ndislocation. The dislocation was successfully treated\nusing the Hippocrates manouvre. No complication\nwas recorded.