Previously undiagnosed MVA trauma to TMJ

Abstract

Temporomandibular disorders (TMD) have a multifactorial aetiology, one suggestion being that facial trauma caused by motor vehicle accidents (MVA) may result in TMD. However, the relationship is somewhat controversial as there is no conclusive evidence.1 Trauma to the temporomandibular joint (TMJ) can be classified as microor macro-trauma. The degree of severity varies from malocclusion, whiplash during MVA and facial fractures including mandibular and condylar fractures. Trauma to the TMJ whether direct or indirect may affect the balance of the TMJ, resulting in degeneration of the articular cartilage by altering the mechanical properties of the disc. A number of problems may be experienced including dislocation, effusion, fibrous adhesions, ankylosis, fracture of the condylar head or neck and limited jaw opening.2 A long-term effect of MVA to the TMJ is a secondary malocclusion developing long after the primary treatment. The most common reason for this malocclusion is that the anteroposterior or transverse dimensions have been altered. In cases where condylar fractures were undiagnosed an open bite will develop, leading to a retrognathic mandible.