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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Mar;109(3):e33-7. doi: 10.1016/j.tripleo.2009.10.046.

Neurogenic temporomandibular joint dislocation treated with botulinum toxin: report of 4 cases.

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Maxillofacial Surgical Department, Joan XXIII Hospital, Tarragona, Spain.


Many patients suffer recurrent episodes of temporomandibular joint (TMJ) dislocation due to an excess of muscle contraction or spasticity in the depressor muscles of the jaw. The manual repositioning using the Nelaton maneuver is the first treatment. Occasionally, it may be necessary to use sedation or general anesthesia to achieve the desired muscle relaxation. In case of recurrence, surgical treatment is indicated. One nonsurgical method of treatment is the local infiltration of botulinum toxin type A. We present 4 cases of recurrent TMJ dislocation in patients suffering from conditions of neurologic origin, with considerable motor deterioration, treated with local infiltration of botulinum toxin type A. In conclusion, the injection of botulinum toxin type A is an effective method in cases of neurogenic TMJ dislocation, with low morbididty and side effects, improving patients' quality of life.

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