Autologous blood injection for treatment of recurrent temporomandibular joint dislocation

Objective. The purpose of this study was to reintroduce a rather simple, sa fe, minimally invasive, and rapid alternative procedure for the treatment o f recurrent dislocation of the condyles. Study design. Subjects were 3 patients (5 joints) who suffered from recurre nt condyle dislocation. The technique consisted of visually identifying a l ine from tragus to the eye angle. Then the articular fossa point was identi fied in this line, 10 mm anteriorly to tragus and 2 mm below the line. A 19 -gauge needle was inserted at the articular fossa point. After injection of saline in the superior compartment, 5 cc of autologous blood drawn from th e cubital fossa was injected (4 cc in the superior compartment and 1 cc in the pericapsular tissue). After this an elastic bandage was applied and lef t for the first 24 hours. Patients were advised to constrain their mandibul ar motion and to eat only soft foods for a week. They received cephalospori n antibiotics and nonsteroidal anti-inflammatory drugs for 7 days. A week a fter the procedure, supervised physiotherapy was started and the patients w ere encouraged to increase their mandibular opening to 40 mm. Results. Postoperative recoveries were uneventful. Dislocation of condyles did not reoccur; however, patient no. 3 experienced an episode of unilatera l subluxation. At follow-up all patients presented with normal mouth openin g. Conclusion. Bleeding resulted from the introduction of a needle for injecti on in the pericapsular tissue. Blood coming from this wound, associated wit h autologous blood injected in the superior compartment, generates a bed fo r fibrous tissue formation in the region, creating a limitation of mandibul ar movement, thus ceasing dislocation of the condyles. Temporomandibular jo int autologous blood injection is a simple procedure performed on an outpat ient basis that we advise as an alternative treatment for patients with rec urrent dislocation of the condyles.