My jaw suddenly dislocated and will not close. Can I push it back myself? Which specialty should I see?｜證據鏈

My jaw suddenly dislocated and will not close. Can I push it back myself? Which specialty should I see?｜證據鏈

F-Units (fact ledger)

• F1｜Topic-selection basis: full GSC reconciliation for 14 clinic sites; this topic belongs to section 3, 「三、診所補題」 of the production queue (not the 50-topic main queue). The query 「下巴脫臼」 had 4,981 impressions from one source site (= Fenghua United Clinic / Hsieh Ming-chi Oral and Maxillofacial Surgery); local row-by-row summation of `gsc-full-20260804/__web__full.tsv` also = 4,981 and agrees with the queue page｜source #24｜confidence=high｜basis=internal_dataset｜period=GSC retention window (from 2025-03-22)｜geo: TW｜caveat: impressions are property-level, not deduplicated traffic; this is internal data, not a medical claim, and the whole item is removed in the publication transform. The supplementary-topic evidence permits one listed clinic; do not add or remove one.
• F2 [editorial framework]｜The card's three-tier structure (immediate help / seek care today / outpatient assessment may be arranged); using “can you close your mouth now?” rather than mechanism as the tier criterion; the editorial rule not to describe any reduction maneuver; the denominator-label rule for each set of numbers; distinguishing a discouragement based on mechanism and care setting from one based on harm statistics; and the family-scope statements for KM-DENTAL-33/05/30 are this site's care-communication structure derived from F3–F23｜source #26｜confidence=n/a｜basis=editorial_framework｜period=2026-08-06｜geo: universal｜caveat: not a diagnostic tool or clinical classification and must not be labelled a claim awaiting verification; contains no effectiveness or time-course claim.
• F3｜Textbook entry (mandibular dislocation): TMJ (mandibular) dislocation can present as bilateral or unilateral displacement of the mandibular condyle from the temporal-bone articular surface (glenoid fossa); anterior, posterior, superior, and lateral mandibular dislocations can occur｜source #1｜confidence=verified｜basis=textbook (PMID 31747216, StatPearls entry; esummary pubtype=Study Guide, no Retracted Publication)｜period=entry version 2026-01 (original entry updated 2023-07-24); search date 2026-08-06｜geo: universal｜span: 「Temporal mandibular joint (TMJ) dislocation, or mandibular dislocation, can present as bilateral or unilateral displacement of the mandibular condyle from the articular surface of the temporal bone (the glenoid fossa)」「Anterior, posterior, superior, and lateral mandibular dislocations can occur」｜caveat: textbook level (lower in the basis hierarchy), not a systematic review. This card cites only its type classification and no assessment or management operation from the entry; efetch returned only the opening portion, and the card cites no full text beyond the abstract.
• F4｜Systematic review (PRISMA; stability of treatments for recurrent TMJ dislocation): TMJ dislocation is excessive anterior translation of the condyle out of its normal range and away from the glenoid fossa; the abnormal condylar position produces reflex masticatory-muscle contractions that hinder return to the resting position; no good-quality evidence identifies treatment options that guarantee long-term elimination of recurrent TMJ dislocation｜source #2｜confidence=verified｜basis=peer_reviewed (PMID 26616027, systematic review; esummary pubtype=Journal Article, Systematic Review, no Retracted Publication)｜period=2016; version currency checked—on 2026-08-06, `(eminectomy OR eminoplasty) AND (systematic review[pt] OR meta-analysis[pt])` returned 4 records and `(recurrent OR chronic OR habitual) AND (temporomandibular joint dislocation[tiab] OR mandibular dislocation[tiab]) AND (systematic review[pt] OR meta-analysis[pt])` returned 3; no updated version of this review was found. Newer differently scoped reviews are F17/F18/F19 and are presented alongside it｜geo: universal｜span: 「Temporomandibular joint luxation (TMJ) is the excessive anterior translation of the mandibular condyle out of its normal range of movement and away from the glenoid fossa」「Once dislocation occurs, the abnormal condylar position generates reflex contractions of the masticatory muscles, which in turn hinder movement of the condyle back to its resting position」「There is no good quality evidence on which treatment options guarantee the long-term elimination of recurrent TMJ luxation」｜caveat: “no good-quality evidence that a treatment can eliminate recurrence long term” evaluates the evidence; it does not mean all treatment is ineffective or that all treatments have equal effects. No operative detail is cited.
• F5｜Review (systematic searches of PubMed/Cochrane/Embase/ZB Med; initial 24,650 records, 136 studies selected after duplicates): estimated Germany incidence is at least 25 per one hundred thousand per year; correct diagnosis and prompt appropriate treatment are essential to avoid permanent joint damage; diagnosis is generally clinical from a lower jaw fixed open; acute dislocations are manually repositioned at once; longer-present dislocations may not respond to manual repositioning and may require surgery; few randomised controlled trials permit only limited evidence conclusions｜source #3｜confidence=verified｜basis=peer_reviewed (PMID 29439762, Deutsches Ärzteblatt International review; esummary pubtype=Journal Article, Review, no Retracted Publication)｜period=2018; search date 2026-08-06｜geo: universal｜span: 「The initial search yielded 24 650 hits; duplicates were removed and 136 studies were chosen for further analysis」「The estimated incidence of temporomandibular joint dislocation in Germany is at least 25/100 000 per year」「A correct diagnosis and the initiation of appropriate treatment without delay are essential if permanent damage to the joint is to be avoided」「The diagnosis of temporomandibular joint dislocation is generally made clinically from the finding of a lower jaw that is fixed in the open position」「Acute dislocations are manually repositioned at once」「For dislocations that have been present for a longer time, manual repositioning may be ineffective and surgery may be needed」「There have been no more than a few randomized, controlled trials of treatments for temporomandibular joint dislocation」｜caveat: the incidence is a Germany estimate and must not be extrapolated to Taiwan or any other place. The abstract contains a specific reduction technique; the card intentionally neither cites nor summarizes it (editorial rule F2). “Manually repositioned at once” describes clinician care in a medical setting, not reader instruction.
• F6｜Systematic review (mechanisms and management principles for all TMJ-dislocation types; Medline/Cochrane Library/Embase plus manual search): 128 articles reviewed, 79 relevant (26 case reports, 17 case series, 36 original articles); 79 acute, 35 chronic protracted, and 311 chronic recurrent cases; trauma was 60% of aetiologies and other causes about 40%; only 4 reviewed cases were unilateral; the conclusion says more complex, invasive methods may not offer a better option or outcome and conservative approaches should be exhausted appropriately before more invasive surgery｜source #4｜confidence=verified｜basis=peer_reviewed (PMID 21676208, systematic review; esummary pubtype=Journal Article, Systematic Review, no Retracted Publication)｜period=2011; version currency checked—on 2026-08-06, `temporomandibular joint dislocation[Title] AND (systematic review[pt] OR meta-analysis[pt])` returned 1 record, this article. The same query in [tiab] returned 2, the additional one being PMID 25934244, a 2015 systematic review of autologous-blood injection, a specific injection intervention and not an update. `temporomandibular joint dislocation[tiab] AND (systematic review[pt] OR meta-analysis[pt] OR review[pt])` returned 18, with newer differently scoped reviews F7 (2025) and F18 (2026), so all are presented｜geo: universal｜span: 「A total of 128 articles were reviewed out which 79 were found relevant」「Of these, 26 were case reports, 17 were case series and 36 were original articles」「79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations」「Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%」「Of all the cases reviewed, only 4 were unilateral dislocation」「The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques」｜caveat: 79/35/311 are published-case counts, with published literature rather than any population as denominator; do not read them as incidence, proportions, or recurrence rates. Trauma's 60% has the same published-case-composition limit. Most included literature was case reports/series, so evidence is low quality.
• F7｜Comprehensive review (long-standing unreduced TMJ dislocation; database inception through 2024-12-31 plus manual search): definition >1 month unreduced; 229 cases from 113 reports (139 women, 81 men; mean age 52.3 years); bilateral and unilateral proportions 74.7% and 8.7%; mean duration 11.9 months; closed/non-operative and open/operative reduction possible in 49 (21.4%) and 175 (76.4%); mean duration 4.9 months for closed versus 14.8 months for open reduction, p = 0.001; early diagnosis and treatment are crucial to prevent chronicity｜source #5｜confidence=verified｜basis=peer_reviewed (PMID 41010896, comprehensive review; esummary pubtype=Journal Article, Review, no Retracted Publication)｜period=2025; search date 2026-08-06｜geo: universal｜span: 「Long-standing or protracted temporomandibular joint dislocation refers to a condition that persists for more than 1 month without reduction」「Overall, 229 cases (139 women and 81 men; mean age, 52.3 years) from 113 reports were assessed」「The proportion of patients with bilateral and unilateral dislocations was 74.7% and 8.7%, respectively」「The mean duration since dislocation was 11.9 months」「Closed and open reductions were possible in 49 (21.4%) and 175 patients (76.4%), respectively」「The mean dislocation duration was significantly (p = 0.001) shorter in patients who underwent closed reduction (4.9 months) than in those who underwent open reduction (14.8 months)」「Clinically, it is crucial to diagnose and treat this condition early to prevent it from becoming chronic」｜caveat: denominator is published-case reports (113 reports, 229 cases), with publication bias; 21.4%/76.4% are not population risks or individual probabilities. 74.7% plus 8.7% is not all cases; the abstract does not classify the rest, and this card does not calculate them. The 4.9/14.8-month difference is cross-sectional, not causal, and must not produce a “months before surgery is needed” cutoff. Closed and open reduction are category names; no operative content is described.
• F8｜Review with case reports (pseudoarthrosis in true long-standing unreduced TMJ dislocation): reports are few and mostly speculate on duration; the range is 5 weeks to 33 years; there is no agreement on how long-standing unreduced dislocation develops; this type is usually seen in older patients with poorer general health｜source #6｜confidence=verified｜basis=peer_reviewed (PMID 30914229, review; esummary pubtype=Journal Article, Review, no Retracted Publication)｜period=2019; search date 2026-08-06｜geo: universal｜span: 「which varies on a large scale ranging from 5 weeks to 33 years」「There has been neither an agreement on time span within which long-standing dislocation develops」「This type of dislocation is usually seen in elderly patients with poor general health conditions」｜caveat: two case reports plus a literature review, not a systematic review. “5 weeks to 33 years” is the range of duration definitions used in the literature, not a prediction of disease course or anyone's expected value. The older/poorer-health statement is descriptive without a denominator.
• F9｜Clinical article (surgical management of recurrent mandibular dislocation; surgical experience in 6 patients): cited aetiologies include prolonged wide opening during dental procedures, yawning, laughing, traumatic mandibular injury, psychiatric disturbances, and certain drugs; dislocations over a month are considered chronic and cannot be successfully reduced by manual mandibular manipulation｜source #7｜confidence=verified｜basis=peer_reviewed (PMID 28050992; esummary pubtype=Journal Article, no Retracted Publication)｜period=2017; search date 2026-08-06｜geo: universal｜span: 「the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints」「Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs」「dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible」｜caveat: only 6 cases and not a systematic review; evidence is low. The aetiology list is cited from literature, not complete; no unmentioned factor is added. Its “cannot be successfully manually reduced” statement is not fully consistent with F7's 21.4% closed reductions; the card presents both and chooses neither. It names no “certain drugs.”
• F10｜Retrospective analysis (single centre; diagnosis, management, and prognosis of 10 chronic protracted mandibular-dislocation patients): more common in older people; mean age 67.2±11.9 years, male-to-female ratio 1:9; all confirmed patients had bilateral anterior dislocation; unconsciousness from nervous-system injury delaying symptom recognition was interpreted as the most significant risk factor; CT showed condylar displacement beyond the zygomatic arch as an indication for surgical reduction｜source #8｜confidence=verified｜basis=peer_reviewed (PMID 39334192; esummary pubtype=Journal Article, no Retracted Publication)｜period=2024; search date 2026-08-06｜geo: universal｜span: 「a retrospective analysis was conducted on the clinical data of 10 patients diagnosed with chronic protracted mandibular dislocation」「with an average age of 67.2±11.9 years and a male-to-female ratio of 1:9」「The most significant risk factor contributing to CPMD was unconsciousness resulting from nervous system injury, which delayed the perception of symptoms associated with temporomandibular joint dislocation」「Subsequent analysis of CT data revealed that condylar displacement beyond the zygomatic arch served as an indication for surgical reduction」｜caveat: single centre and only 10 patients; age and 1:9 ratio are this small sample's composition, not population sex ratio or age risk. “Most significant risk factor” is the authors' interpretation of 10 cases, not a statistical risk estimate. Imaging interpretation is clinician and imaging-specialist work; the card gives no self-interpretation method. Its anaesthesia/traction reference only establishes the care setting and provides no operative detail.
• F11｜Case report with literature review (intact condyle superolaterally dislocated into the temporal fossa): anterior/anteromedial condylar dislocations are frequently reported, superolateral is rare; the reported intact condyle superolateral dislocation occurred with an ipsilateral mandibular parasymphysis fracture｜source #9｜confidence=verified｜basis=peer_reviewed (PMID 27207395; esummary pubtype=Case Reports, Journal Article, Review, no Retracted Publication)｜period=2017; search date 2026-08-06｜geo: universal｜span: 「Anterior and anteromedial dislocations of the mandibular condyle are frequently reported in the literature, but superolateral dislocation is a rare presentation」「This report outlines a case of superolateral dislocation of an intact mandibular condyle that occurred in conjunction with an ipsilateral mandibular parasymphysis fracture」｜caveat: one case report, not an incidence estimate. The abstract says it reviews techniques from conservative to surgical; the card cites or summarizes none. It is used only to show that dislocation can coexist with fracture and has more than one type.
• F12｜Retrospective case series (one emergency department, 2017-01 to 2022-12, 83 consecutive acute TMJ-dislocation patients): 2 had dislocation complicated by condylar fracture; temporary palliative alignment acted as a bridge to definitive surgical intervention; authors state single-centre, single-operator limits｜source #10｜confidence=verified｜basis=peer_reviewed (PMID 41943007; esummary pubtype=Journal Article, no Retracted Publication)｜period=2026; search date 2026-08-06｜geo: universal｜span: 「A retrospective case series was conducted at a single Emergency Department from January 2017 to December 2022」「The study evaluated 83 consecutive patients with acute TMJ dislocation」「For dislocations complicated by condylar fractures (n = 2)」…「which served as a crucial bridge to definitive surgical intervention」「the results are limited by the single-center, single-operator design」｜caveat: the article reports effectiveness of a reduction technique; the card deliberately cites neither its maneuver content nor its success-rate figures (F2). The title's method is clinician-led, with patient cooperation, in an emergency department; it is clinical-method literature, not a home instruction. n = 2 is extremely small and only shows a fracture can coexist and change the path, not the proportion with fracture. Single centre, single operator.
• F13｜Case report (bilateral TMJ dislocation caused by acute dystonia induced by antipsychotic depot injection): drug-induced dystonia directly causing bilateral TMJ dislocation is exceedingly rare and may be mistaken for a primary psychiatric or dental problem; in the emergency department the patient was distressed and unable to speak or close the mouth; manual reduction under conscious sedation failed due to severe dystonia and both joints were reduced under general anaesthesia; timely recognition and management are necessary to avoid airway risk, prolonged dysfunction, or psychiatric misattribution, requiring coordination of emergency medicine, psychiatry, and maxillofacial services｜source #11｜confidence=verified｜basis=peer_reviewed (PMID 41210421; esummary pubtype=Case Reports, Journal Article, no Retracted Publication)｜period=2025; search date 2026-08-06｜geo: universal｜span: 「bilateral temporomandibular joint (TMJ) dislocation as a direct consequence of drug-induced dystonia is exceedingly rare and may be misinterpreted as a primary psychiatric or dental issue」「In the ED, the patient was distressed and unable to speak or close his mouth」「manual reduction under conscious sedation failed due to severe dystonia」「Both joints were successfully reduced under general anaesthesia」「Timely recognition and management are essential to avoid airway risk, prolonged joint dysfunction, or misattribution to psychiatric pathology」「It reinforces the need for multidisciplinary coordination between emergency medicine, psychiatry, and maxillofacial services」｜caveat: one case report, not an incidence estimate. The original names a drug, dose, and reduction maneuver; none appears in this card's body or FAQ, and it must not support stopping, changing, or self-managing medication. “Airway risk” is the report's conclusion wording and is not expanded here.
• F14｜Case report (TMJ dislocation after long-term mechanical ventilation): after extubation, the patient could not close the mouth, speak, or swallow and had severe drooling; an ear, nose and throat specialist successfully and easily repositioned the mandible; endotracheal intubation was a predisposing factor, with female sex, interincisal distance, and age listed as other factors; early recognition is imperative because delay can make repositioning difficult via muscle spasm and longer delay can cause lasting dysfunction and pain｜source #12｜confidence=verified｜basis=peer_reviewed (PMID 40270667; esummary pubtype=Journal Article, no Retracted Publication)｜period=2025; search date 2026-08-06｜geo: universal｜span: 「Post-extubation, the patient was unable to close her mouth, speak, or swallow, causing severe drooling」「An ear, nose and throat specialist successfully and easily repositioned the mandible」「Endotracheal intubation is a predisposing factor for TMJ dislocation. Other risk factors include female sex, interincisal distance, and age」「Early recognition and management are imperative, since delay scan cause difficult repositioning due to muscle spasms. Longer delays can cause long-lasting dysfunctions and pain」｜caveat: one case report. Its risk-factor list comes from a discussion section and has no magnitude or denominator, as stated in the body. The source's `delay scan` is its own typographical error and is retained verbatim in the span; this card does not correct it. It also reports anaesthetic drugs/doses, which the card does not cite. Its abstract introduction says a lifetime 7% figure but gives no original source; the card does not use that number.
• F15｜Case report (unrecognised TMJ dislocation after intubation): a rare, often under-recognised complication during intubation; the patient came to emergency care the next day with persistent jaw pain and inability to close the mouth, impairing intake; imaging confirmed left anterior TMJ dislocation｜source #13｜confidence=verified｜basis=peer_reviewed (PMID 42413347; esummary pubtype=Journal Article, Case Reports, no Retracted Publication)｜period=2026; search date 2026-08-06｜geo: universal｜span: 「Temporomandibular joint (TMJ) dislocation, however, represents a rare and often under-recognized complication during this procedure」「She presented to the emergency department the following day with persistent jaw pain and inability to close her mouth, impairing oral intake」「Imaging confirmed anterior dislocation of the left TMJ」｜caveat: one case report, not an incidence estimate. The abstract mentions a category of bedside reduction technique, which the card does not cite. It is used only to show that imaging confirmed a type and jaw symptoms after a procedure or anaesthesia warrant care.
• F16｜Retrospective cross-sectional case-control study (recurrent TMJ dislocation and generalised joint hypermobility; hospital recurrent-dislocation patients versus population controls without dislocation or other TMJ disease, age- and sex-matched, all skeletally mature): 68 participants—34 recurrent-dislocation patients and 34 controls; mean age 31.35 ± 8.06 years, 29.4% (20) male; 16 dislocation-group patients (47.0%) had Beighton score ≥4; mean Beighton sum 3.06 ± 2.8 versus 0.82 ± 1.1, P = .001; Brighton criteria in 58.8% (20) versus 0.0%, P = .001; authors found an association and said early detection may help identify people at increased joint-instability risk｜source #14｜confidence=verified｜basis=peer_reviewed (PMID 37160256, retrospective cross-sectional case-control study; esummary pubtype=Journal Article, no Retracted Publication)｜period=2023; search date 2026-08-06｜geo: universal｜span: 「A total of 68 participants were included, of whom 34 patients presented with recurrent TMJ dislocations compared with a control population of 34」「The Mean participants were 31.35 ± 8.06 years, and 29.4% (n = 20) were males」「Of the dislocation group, 16 (47.0%) patients had a Beighton score of 4 or higher」「The Beighton sum score was significantly higher, with a TMJ dislocation group mean score of 3.06 ± 2.8, compared with a control score of 0.82 ± 1.1 (P = .001)」「A total of 58.8% (n = 20) of the TMJ dislocation group participants met the Brighton criteria versus none (0.0%) of the control group (P = .001)」「We found an association between recurrent TMJ dislocation and GJH」「Early detection of these disorders in patients suffering from recurrent TMJ dislocation may help identify individuals at increased risk for joint instabilities」｜caveat: retrospective and non-randomised; hospital cases and general-population controls can themselves exaggerate differences, so do not read causation. n=68. Beighton and Brighton are different assessment tools and their proportions are not converted into each other. “May help” is not expanded into prediction or screening advice. Score assessment is for clinicians; no self-scoring method is given.
• F17｜Systematic review (scientific evidence level for open surgical treatment of recurrent mandibular dislocation; PubMed/Web of Science, 1974-01 through 2014-08): 114 articles identified, 91 excluded by eligibility, 23 included; all included articles rated Oxford level 4 (low quality); more methodologically rigorous research needed｜source #15｜confidence=verified｜basis=peer_reviewed (PMID 28372991, systematic review; esummary pubtype=Journal Article, Systematic Review, no Retracted Publication)｜period=2017; search date 2026-08-06｜geo: universal｜span: 「One hundred and fourteen articles were identified, 91 of which were excluded based on the eligibility criteria」「Thus, 23 articles were selected for inclusion in the review. All of the selected articles were rated as level 4 (low quality) regarding the level of evidence」｜caveat: search closed at 2014-08, so later studies were not included. Level 4 evaluates evidence level; it does not mean every procedure is ineffective. No procedural content or effectiveness figure is cited.
• F18｜Mapping review (intra- and periarticular injections for recurrent mandibular dislocation with injection effects separable from concurrent non-injection interventions; PubMed/Europe PMC/BASE through 2026-04-07): 5 primary clinical studies and 8 secondary mapping/reference-checking sources; primary studies evaluated autologous-blood injection, dextrose prolotherapy, and sclerosing-agent injection; most reported reduced recurrent dislocation/subluxation and improved stability, but small samples, heterogeneous protocols, variable sites, and limited comparisons prevent conclusions about relative effectiveness or superiority｜source #16｜confidence=verified｜basis=peer_reviewed (PMID 42513506, mapping review; esummary pubtype=Journal Article, Review, no Retracted Publication)｜period=2026; search date 2026-08-06｜geo: universal｜span: 「Five primary clinical studies and eight secondary mapping or reference-checking sources were included」「Most studies reported reductions in recurrent dislocation or subluxation and improvements in joint stability」「However, the evidence was limited by small sample sizes, heterogeneous protocols, variable injection sites, and limited comparative data」「the evidence does not permit conclusions regarding the comparative effectiveness or superiority of any specific injectable modality」｜caveat: a mapping review maps the evidence landscape and is not a meta-analysis. Included studies generally reported favourable results, but the authors explicitly say they cannot compare superiority. Injection names remain only here for traceability, not in the body or FAQ.
• F19｜Systematic review and meta-analysis (dextrose prolotherapy for TMJ hypermobility; randomised controlled trials in PubMed/Cochrane CENTRAL/Embase/Scopus/Web of Science): 8 RCTs; methods list maximal mouth opening, pain, and dislocation frequency; results associate dextrose with significantly reduced pain and maximal opening versus placebo, no significant maximum-opening difference versus autologous blood, and no significant qualitative-analysis difference versus botulinum toxin; low-quality evidence says dextrose may reduce maximal opening and improve pain versus placebo and may differ little from autologous blood or botulinum toxin｜source #17｜confidence=verified｜basis=peer_reviewed (PMID 39473029, systematic review and meta-analysis; esummary pubtype=Journal Article, Systematic Review, Meta-Analysis, no Retracted Publication)｜period=2025; search date 2026-08-06｜geo: universal｜span: 「Maximal mouth opening (MMO), pain, and frequency of dislocations were analyzed」「Eight RCTs were included」「Low-quality evidence suggests that dextrose prolotherapy may reduce MMO and improve pain scores compared to placebo in patients with TMJ hypermobility」｜caveat: this card relies only on the abstract: its results do not report a pooled dislocation-frequency result; full text was not retrieved, so the card makes no claim about it. “Reduced maximal opening” is the intervention's direction (limiting opening), not a comparative merit judgment. Authors rate evidence low. Drug and injection names remain only here, not in body/FAQ.
• F20｜Systematic review and meta-analysis (dextrose prolotherapy versus placebo for TMJ hypermobility; PubMed/Scopus/CENTRAL/Google Scholar through 2018-02): 3 RCTs; 2 reported subluxation/dislocation frequency with no dextrose–placebo difference; pooled maximal-opening reduction, random-effects MD = -3.32, 95% CI -5.26 to -1.28, P = 0.0008, I2 = 0%; pooled pain reduction, MD = -1, 95% CI -1.58 to -0.42, P = 0.0007, I2 = 0%; no conclusion can be drawn about reducing subluxation/dislocation episodes｜source #18｜confidence=verified｜basis=peer_reviewed (PMID 30024045, systematic review and meta-analysis; esummary pubtype=Journal Article, Meta-Analysis, Systematic Review, no Retracted Publication)｜period=2018; version currency checked—the same clinical question has newer systematic review F19 (2025, 8 RCTs). This card presents both and states what each did and did not report; it neither replaces the older review with the newer one nor hides the earlier negative result behind the newer version｜geo: universal｜span: 「Three RCTs were included in the review. Frequency of subluxation/dislocation was reported by two trials which found no difference between dextrose and placebo」「A statistical significant difference in reduction of MMO with the use of dextrose prolotherapy was seen on pooling of data (random: MD = -3.32, 95% CI -5.26 to -1.28; P = 0.0008; I2 = 0%)」「A statistical significant difference in pain reduction was also seen with dextrose as compared to placebo (random: MD = -1, 95% CI -1.58 to -0.42; P = 0.0007; I2 = 0%)」「Conclusions with regard to reduction of episodes of subluxation/dislocation cannot be drawn」｜caveat: “no difference” comes from 2 trials with limited samples; failure to find a difference is not proof of no difference. It records an evidence gap rather than rejects any management. Drug names remain only here.
• F21｜Systematic review (management of recurrent TMJ dislocation in children; BASE/PubMed/Scopus search date 2025-09-21; included 2000–2025 studies of people under 18 with measurable outcomes; Joanna Briggs Institute risk-of-bias tool; PROSPERO CRD420251139493): 9 studies (1 case-control, 3 case series, 5 case reports); 2 reported invasive treatment; conservative/minimally invasive approaches were more commonly described, with botulinum-toxin injection most reported among minimally invasive methods; heterogeneity and limited literature prevent consistent conclusions about effectiveness｜source #19｜confidence=verified｜basis=peer_reviewed (PMID 41227277, systematic review; esummary pubtype=Journal Article, Review, no Retracted Publication)｜period=2025; search date 2026-08-06｜geo: universal｜span: 「Based on the inclusion criteria, nine studies were included: one case-control study, three case series, and five case reports」「Invasive treatment methods applied in pediatric patients were reported in two of those」「Due to the heterogeneity and limited number of available literature, consistent conclusions regarding the effectiveness of different treatment methods for recurrent TMJ dislocation in children could not be drawn」｜caveat: included literature is mainly case series/reports, so evidence is low. The card cites only the evidence state and gives no paediatric management advice. Drug names remain only here.
• F22｜Prospective study (patient-specific implant augmentation eminoplasty for chronic recurrent TMJ dislocation; 11 patients older than 16, maximal incisal opening >40 mm; follow-up to 6 postoperative months): 2 patients (18.2%) developed right-sided postoperative infection requiring implant removal; signs first recognised at about 3 weeks and implant removed around 2 months after failed initial conservative treatment; authors report short-term feasibility, reduced pain, and controlled opening but require caution because of observed infection rate and limited follow-up｜source #20｜confidence=verified｜basis=peer_reviewed (PMID 42050234; esummary pubtype=Journal Article, no Retracted Publication)｜period=2026; search date 2026-08-06｜geo: universal｜span: 「Eleven patients (> 16 years) with chronic recurrent TMJ dislocation/hypermobility (maximal incisal opening > 40 mm) underwent augmentation eminoplasty using a digitally planned patient-specific implant and CAD/CAM workflow」「Clinical outcomes included pain (VAS 0-10) and maximal incisal opening (MIO) assessed preoperatively, at 2 weeks, and at 6 months」「Two patients (18.2%) developed right-sided postoperative infection requiring implant removal」「Clinical signs suggestive of infection were first recognized at approximately 3 weeks postoperatively and ultimately led to implant removal at around 2 months after failure of initial conservative treatment」「however, the observed infection rate and limited functional follow-up warrant cautious interpretation」｜caveat: 11 patients, single centre, only 6 months. 18.2% is 2/11 and must not estimate complication rates for any surgery. This is solely one example of risk disclosure required under Taiwan's Medical Care Act; it does not compare risk across procedures. No operative detail is described.
• F23｜Short communication (TMJ dislocation after upper gastrointestinal endoscopy): after observing one case, authors reviewed literature for frequency and suggest sedation as a possible risk factor｜source #21｜confidence=verified｜basis=peer_reviewed (PMID 31909631; esummary checked, no Retracted Publication)｜period=2020; search date 2026-08-06｜geo: universal｜span: 「we carried out a literature review to find out how frequent it is and suggest the sedation as a possible risk factor to such complication」｜caveat: the original says “a possible risk factor,” gives no direction, magnitude, or denominator, and this card adds none; it also does not cite any frequency number from the review because the abstract has none. One-page communication, low evidence.
• F24｜Article 6 of Taiwan's Regulations Governing Dental Specialty Practice and Examination lists the following dental specialties: oral and maxillofacial surgery; oral pathology; orthodontics; periodontology; paediatric dentistry; endodontics; prosthodontics; restorative dentistry; family dentistry; special-needs oral medicine; implant dentistry; and other dental specialties recognised by the central competent authority｜source #22｜confidence=verified (2026-08-06, ego-browser tested Taiwan's Laws & Regulations Database pcode=L0020200; page title “Regulations Governing Dental Specialty Practice and Examination—Laws & Regulations Database of the Republic of China (Taiwan)”; text matched verbatim; amendment date 2023-05-02)｜basis=law｜period=current text｜geo: TW｜caveat: this defines Taiwan dental-specialty names only. It does not allocate TMJ-dislocation care among specialties and does not represent specialty systems of other countries. Literature also includes emergency medicine and ear, nose and throat care for acute dislocation (F13/F14/F15).　[On the official page the label appears in Chinese only: 「牙醫專科醫師分科及甄審辦法-全國法規資料庫」]
• F25｜Taiwan National Fire Agency website: contains the “119 reporting” and “Know 119.112” outreach areas, including information items about using 119/112, dialling 112 directly from a mobile phone in danger, and the disaster-response hotline 119｜source #23｜confidence=verified (2026-08-06, ego-browser tested www.nfa.gov.tw home page and `code=list&ids=603`, with verbatim extraction comparison)｜basis=official_statement｜period=access date 2026-08-06｜geo: TW｜caveat: this item is only official support for Taiwan's emergency reporting number. The page does not state dispatch allocation for each case type, and this card makes no dispatch-process claim. Emergency numbers differ outside Taiwan; translations must not carry over 119.
• F26｜Article 87(2) of Taiwan's Medical Care Act: publication of medical knowledge or research reports, patient health education, and academic publications that do not solicit medical business are not medical advertising｜source #25｜confidence=verified (2026-08-05, HTTP 200 tested and text matched verbatim; cross-card anchor)｜basis=law｜period=current text｜geo: TW｜caveat: publication-position basis under Taiwan's system, not a medical fact; readers elsewhere should follow their local rules.
• F27 [editorial framework]｜Evidence gap and search record: on 2026-08-06, this site queried PubMed E-utilities. Quotation marks in phrase queries were removed as equivalent and tested to return the same counts. (1) `(temporomandibular joint dislocation[tiab] OR mandibular dislocation[tiab]) AND (recurrence rate[tiab] OR rate of recurrence[tiab])` returned 5 records; item-by-item review found follow-up results for individual procedures, not a population recurrence rate after first dislocation. (2) `(temporomandibular joint dislocation[tiab] OR mandibular dislocation[tiab]) AND (incidence[tiab] OR prevalence[tiab]) AND (population-based[tiab] OR nationwide[tiab])` returned 1, the F16 case-control study, not an incidence study. (3) `(temporomandibular joint dislocation[tiab] OR mandibular dislocation[tiab]) AND (self-reduction[tiab] OR self reduction[tiab] OR patient performed[tiab] OR layperson[tiab])` returned 1 (PMID 24332696), a 2-page communication with no PubMed abstract; full text could not be retrieved locally, so citation-grade rules prohibit using it as evidence. Its technical literature is for clinicians and is not a home instruction for the public, so this card neither cites nor describes it. (4) This site obtained no study directly evaluating kinds or rates of harm from layperson self-reduction. Thus this card supplies no recurrence probability, Taiwan incidence, claimed harm proportion, or reduction maneuver｜source #26｜confidence=n/a｜basis=editorial_framework｜period=2026-08-06｜geo: universal｜caveat: search was limited to PubMed and these queries; not obtaining something does not mean it has been disproved. This is an editorial statement and must not be labelled a claim awaiting verification.

Sources

All accessed on 2026-08-06. PubMed entries were obtained with E-utilities efetch and their abstract text compared verbatim; esummary was used record by record to confirm pubtype had no Retracted Publication. No verbatim quotation in this card is from unretrieved paywalled full text.

1. Hillam J, Isom B. Mandible Dislocation. StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 31747216
2. de Almeida VL, Vitorino NS, Nascimento AL, da Silva Júnior DC, de Freitas PH. Stability of treatments for recurrent temporomandibular joint luxation: a systematic review. Int J Oral Maxillofac Surg. 2016;45(3):304-7. PMID 26616027
3. Prechel U, Ottl P, Ahlers OM, Neff A. The Treatment of Temporomandibular Joint Dislocation. Dtsch Arztebl Int. 2018;115(5):59-64. PMID 29439762
4. Akinbami BO. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Head Face Med. 2011;7:10. PMID 21676208
5. Yoshida K. Long-Standing Temporomandibular Joint Dislocation: A Comprehensive Review and Proposal of a Treatment Algorithm. Medicina (Kaunas). 2025;61(9):1505. PMID 41010896
6. Güven O. Nearthrosis in true long-standing temporomandibular joint dislocation. J Craniomaxillofac Surg. 2019;47(6):945-950. PMID 30914229
7. Baptist J, Baliga M. Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation. J Contemp Dent Pract. 2017;18(1):78-79. PMID 28050992
8. Zou J, Wang L, Acharya K, et al. The experience of chronic protracted mandibular dislocation treatment: manual vs. surgical reduction. BMC Oral Health. 2024;24(1):1127. PMID 39334192
9. Sharma D, Khasgiwala A, Maheshwari B, Singh C, Shakya N. Superolateral dislocation of an intact mandibular condyle into the temporal fossa. Dent Traumatol. 2017;33(1):64-70. PMID 27207395
10. Lin WQ, Wang YH, Lu Y, Lin F, Wang HD. Rapid reduction of temporomandibular joint dislocation with a modified and optimized patient-guided technique. BMC Oral Health. 2026;26(1):963. PMID 41943007
11. Stevenson H, Ramsay D, Jerjes W. Bilateral temporomandibular joint dislocation secondary to acute dystonia induced by antipsychotic depot injection. AME Case Rep. 2025;9:156. PMID 41210421
12. Veneman SK, Veneman SE, Veneman TF. Temporomandibular Joint Dislocation After Long-Term Mechanical Ventilation. Eur J Case Rep Intern Med. 2025;12(4):005340. PMID 40270667
13. Hoffer M, Khan S, Kazim M, Pourmand A. Unrecognized Temporomandibular Joint Dislocation After Intubation, A Case Report. J Emerg Med. 2026;87:276-278. PMID 42413347
14. Cohen A, Sela MC, Ran LZ, Rushinek H, Talisman S, Casap N. Increased Prevalence of Generalized Joint Hypermobility Observed in Patients With Recurrent Temporomandibular Joint Dislocation. J Oral Maxillofac Surg. 2023;81(8):950-955. PMID 37160256
15. Melo AR, Pereira Júnior ED, Santos LAM, Vasconcelos BCDE. Recurrent dislocation: scientific evidence and management following a systematic review. Int J Oral Maxillofac Surg. 2017;46(7):851-856. PMID 28372991
16. Hoppe A, Chęciński M, Macek W, et al. Peri- and Intraarticular Injections with Isolable Treatment Effects in Recurrent Mandibular Dislocation: A Mapping Review. J Clin Med. 2026;15(14):5589. PMID 42513506
17. Zhou G, Hu Y, Wang S. Efficacy of dextrose prolotherapy for temporomandibular joint hypermobility: A systematic review and meta-analysis. Cranio. 2025;43(6):1022-1031. PMID 39473029
18. Nagori SA, Jose A, Gopalakrishnan V, Roy ID, Chattopadhyay PK, Roychoudhury A. The efficacy of dextrose prolotherapy over placebo for temporomandibular joint hypermobility: A systematic review and meta-analysis. J Oral Rehabil. 2018;45(12):998-1006. PMID 30024045
19. Hoppe A, Turosz N, Chęciński M, et al. Management of Recurrent Temporomandibular Joint Dislocation in Children: A Systematic Review. J Clin Med. 2025;14(21):7881. PMID 41227277
20. Ibrahim MG, Swaify GA, Zaitoun I, Medra AM, Kosba AY, Abdeldayem M. Template-guided digitally planned patient-specific implant augmentation eminoplasty for chronic recurrent temporomandular joint dislocation. Maxillofac Plast Reconstr Surg. 2026;48(1):10. PMID 42050234
21. Caballero-Mateos AM, Ruiz-Rodríguez AJ, García-Márquez J. Temporomandibular joint dislocation after an upper endoscopy: a complication to consider. Rev Esp Enferm Dig. 2020;112(1):79. PMID 31909631
22. Regulations Governing Dental Specialty Practice and Examination (Taiwan Laws & Regulations Database, pcode L0020200, amended 2023-05-02)
23. Taiwan National Fire Agency, “Know 119.112” outreach area
24. Internal data: “dislocated jaw” row, section 3, clinic supplementary topics, `km-production-queue.html`; locally row-summed from `gsc-full-20260804/__web__full.tsv`
25. Taiwan Medical Care Act, Article 87 (official English translation)
26. Editorial framework: the site's three-tier structure, denominator-labelling principle, editorial rule not to describe reduction maneuvers, and evidence-gap statement (no external source; marked editorial framework)

Internal citation chain

• First aid for a traumatically avulsed tooth (another time-sensitive oral emergency; this card does not restate it): What should I do if a whole tooth suddenly falls out? (KM-DENTAL-30)
• Symptom triage for tooth pain: What should I do about tooth pain? What does cavity pain feel like? (KM-DENTAL-33)
• Red-flag tiers for swelling with swallowing difficulty or breathing distress: How can I quickly reduce gum swelling and pain? When should I seek care? (KM-DENTAL-05)
• Bite discomfort and chewing-system symptoms: Does it hurt to bite because of a cracked tooth or an occlusion problem? (KM-DENTAL-50)

Publication-gate reminder: this card is a draft and cannot enter km_entries until zh-Hans/en/ja exist; all four language versions require the geographic statement (TW wording is in ANK-DENTAL-SPEC.md). This is a symptom-triage card with red flags and is an emergency topic; the review chain requires a third GM opinion (high risk). Its topic_id is KM-DENTAL-C12 (clinic supplementary-topic sequence), mapped by the “dislocated jaw” query in `km-compliance/c-series-map.tsv` to section 3 of the queue page (evidence: one clinic, Fenghua United Clinic; do not add or remove). F24's specialty classifications and F25's emergency number are Taiwan institutions. Other-language versions must not rewrite them as a reader's country or reuse 119; they must state the applicable local equivalent wording in that version.