Post-traumatic disorders of the jaw joint.

A group of 165 patients with surgical diseases of the temporomandibular joint treated in 3 Australian university hospitals is reviewed. A facial trauma is relatively common patients have been included in the post-traumatic group only if there was an undisputed history of injury requiring medical or dental treatment or admission to hospital. In 38.3% of patients with histologically proven osteoarthritis there was an undisputed history of trauma. In a further group with recurrent mandibular dislocation 62.6% were post-traumatic. Trauma was the cause of 62.5% of cases of mandibular ankylosis. There is a general tendency to underdiagnose degenerative joint disease and to perpetuate conservative treatment when it is crystal clear that these measures are not being successful. It is probable that intracapsular fractures of the jaw joint are frequently undiagnosed and a higher index of suspicion is required. Mandibular ankylosis continues to pose some difficulty of management and a critical review confirms that wide surgical exposure of the joint is essential; the importance of long-term review is stressed. The outcome of the surgical treatment of recurrent luxation is excellent and an operation of commendable simplicity is advocated.