MANDIBULAR REDUCTION MANEUVERS IN CASES OF RECURRENT DISLOCATION: EVIDENCE-BASED UPDATE

Abstract

Recurrent mandibular dislocation is a clinical condition that compromises the function of the temporomandibular joint, characterized by the repeated displacement of the mandibular condyle out of the glenoid cavity, usually in an anterior direction, without spontaneous return. This condition causes pain, functional limitation, anxiety and a direct impact on the quality of life of patients, and technical mastery of the available reduction maneuvers is essential. Traditionally, the Hippocrates technique has been the most widely used, due to its simplicity and wide dissemination in clinical practice. However, this approach has disadvantages, such as risk of injury to the operator, discomfort to the patient, need for excessive force and a greater chance of complications in certain contexts. With the evolution of techniques and improvements in clinical conduct, alternatives have emerged, such as the syringe maneuver, the supine method with posterior manipulation and self-reduction techniques, which have proven to be effective, safe and less traumatic. In addition, complementary resources such as anesthetic blocks, conscious sedation and application of botulinum toxin type A have been successfully explored in the prevention of new episodes and in improving the patient's experience during treatment. Given the diversity of therapeutic options, it is essential to know the indications, contraindications, advantages and limitations of each technique. This article presents an evidence-based update on the main mandibular reduction maneuvers used in cases of recurrent dislocation, aiming to support the dentist in choosing the most appropriate, safe and effective approach for each clinical situation, based on anatomical and functional criteria and experience accumulated in specialized literature.