Article Contents
A patient presented with a unilateral dislocated condyle that was resistant to reduction by simple manual manipulation because of elevator muscle spasm and severe muscle and temporomandibular joint pain. A technique involving a masseteric nerve block and a temporal nerve block was used, allowing a quick, safe, and minimally painful reduction. The method used for delivering these nerve blocks is described here.Abstract
Section of panoramic radiograph showing dislocated right condyle.
Dissection of the right masseteric nerve. The masseteric nerve branches off from the mandibular division of the trigeminal nerve, then passes through the mandibular notch before penetrating the masseter.
Visualization of the width of the ramus by grasping the anterior and posterior borders with the thumb and middle finger.
The index finger locates the zygomatic arch at a point halfway between the thumb and the middle finger.
The index finger moves inferiorly until it reaches the mandibular notch.
The needle is introduced posterior to the index finger; hitting the neck of the condyle is attempted.
Image of needle insertion, toward the neck of the condyle.
Contributor Notes
Address correspondence to Dr Andrew L Young, 110 Bergen Street, Reception Area 12, Room D-881, University Heights, Newark, New Jersey, e-mail: andrewyoungdds@yahoo.com
eISSN: 1878-7177
ISSN: 0003-3006