J Oral Maxillofac Surg 67:114-119, 2009 Autologous Blood Injection for the Treatment of Chronic Recurrent Temporomandibular Joint Dislocation Vladimir Machon, MD, DMD,* Shelly Abramowicz, DMD, MPH,† Jan Paska, MD,‡ and M. Franklin Dolwick, DMD, PhD§ Purpose: Many different surgical techniques for the treatment of chronic recurrent temporomandib- ular joint (TMJ) dislocation have been described. This article discusses a technique of autologous blood injection to the TMJ for treatment of chronic recurrent TMJ dislocation. Materials and Methods: Twenty-five patients diagnosed with chronic recurrent TMJ dislocation were treated by bilateral injections of autologous blood into the upper joint space and around the TMJ capsules bilaterally. Results: Eighty percent had a successful outcome and required no further treatment at their 1-year follow-up. Conclusion: This procedure has proven to be safe, simple, and cost effective for the treatment of chronic recurrent TMJ dislocation. © 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:114-119, 2009 Temporomandibular joint (TMJ) dislocation occurs when the condyle travels anterior to the articular eminence and remains there. Chronic recurrent TMJ dislocation may occur as a result of everyday activities such as yawning or laughing, or during events that require mouth opening for a continuous amount of time such as during dental treatment. Chronic recur- rent TMJ dislocation is distressing because it is painful and because it interferes with daily activities. As a result, this condition may adversely affect an individ- ual’s life. 1 The pathogenesis of chronic recurrent TMJ disloca- tion is attributed to a combination of factors including laxity of the TMJ ligaments, weakness of the TMJ capsule, an unusual eminence size or projection, mus- cle hyperactivity or spasms, trauma, and abnormal chewing movements that do not allow the condyle to translate back. 2,3 Recurrent dislocation of the TMJ may cause injury to the disc, the capsule, and the ligaments, leading to progressive TMJ internal de- rangement. 3,4 To treat this condition, nonsurgical in- terventions have been pursued, including restriction of mandibular range of motion combined with muscle relaxants and a soft diet, 5 application of local anes- thetics, 2 injection of botulinum toxin to various mus- cles of mastication, 6-9 and injection of sclerosing agents. 10,11 Conservative treatment methods are not always successful; therefore, multiple surgical inter- ventions were developed including eminectomy, 12 capsular plication, 13 temporalis tendon scarifica- tion, 14 and lateral pterygoid myotomy. 15,16 In addi- tion, there are general anesthetic risks as well as surgical risks associated with these procedures. Autologous blood injection to the TMJ as a treat- ment of chronic recurrent TMJ dislocation was first reported by Brachmann, in 1964. 17 Several articles followed, 14,18-20 but for unclear reasons, autologous *Resident, Department of Head and Neck Surgery, Hospital Ho- molka, Prague, Czech Republic. †Formerly, Chief Resident, Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, Gainesville, FL; and Currently, Instructor of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Department of Plastic and Oral Surgery, Children’s Hospital, Boston, MA. ‡Assistant Professor, Department of Head and Neck Surgery, Hospital Homolka, Prague, Czech Republic. §Professor and Chairman, Department of Oral and Maxillofacial Surgery, University of Florida College of Dentistry, Gainesville, FL. Address correspondence and reprint requests to Dr Abramo- wicz: Department Plastic and Oral Surgery, 300 Longwood Avenue, Hunnewell 100, Boston, Massachusetts 02115; e-mail: shelly. abramowicz@childrens.harvard.edu © 2009 American Association of Oral and Maxillofacial Surgeons 0278-2391/09/6701-0017$34.00/0 doi:10.1016/j.joms.2008.08.044 114