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.
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.