OM was a 26-year-old male student who\npresented with chronic recurrent TMJ dislocation\nfollowing wide mouth opening (yawning) of about\none day duration having had about 10 previous\nepisodes (talking, laughing, yawning) all of which were\nsuccessfully treated with the Hippocrates manouvre.\nHe presented with a desire for a definitive treatment.\nPlain X-rays (TMJ views) revealed short mandibular\ncondyles. He had reduction using the Hippocrates\nmanouvre and subsequent immobilization with maxillomandibular\nfixation for two weeks but had a recurrence\nimmediately after. Definitive care was bilateral\neminectomy which involved grounding down of the\narticular eminences using round/acylic burs under\ngeneral anesthesia. There was complete resolution of\nsymptoms, restoration of temporomandibular joint functions and resolution of associated facial nerve\nweakness at five month post-operative review.
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.