Dautrey's procedure: an alternative for the treatment of recurrent mandibular dislocation in patients with pneumatization of the articular eminence

Abstract

Temporomandibular joint (TMJ) dislocation is an involuntary forward movement of the mandible beyond the articular eminence with the condyle remaining stuck in the anterior-most position, leaving the patient unable to close their mouth. Conservative treatment for this condition includes the injection of sclerosing agents or the intramuscular administration of botulinum toxin type A, while surgical therapy requires either removal or augmentation of the articular eminence. Once the surgical treatment plan has been determined, pneumatization of the articular eminence may turn a relatively simple procedure into a great surgical challenge. We present herein the cases of two patients suffering from recurrent mandibular dislocation who happened to have pneumatization of the articular eminences. Both patients were treated with a down-fracture of the zygomatic arch, known as Dautrey's procedure, modified by the application of a miniplate connecting the displaced arch and the lateral portion of the articular eminence. Neither patient had suffered a new episode of dislocation at their most recent postsurgical visit.