Conference Coverage

Mandible Fractures Associated With Higher Hospital Use in TMJ Dislocation

Edited by:
Ashton L. Stahl

Key Highlights

  • Among 2,070 patients with temporomandibular joint dislocation, 57.6% were female, and the mean age was 42.4 years.
  • Concomitant mandible fractures occurred in 9% of patients and were more common among males than females (15% vs 4.5%; P < .001).
  • Patients with a mandible fracture had higher mean emergency department charges than those without a fracture ($13,829 vs $6,005; P < .001).
  • Hospital admission occurred in 88.7% of patients with a mandible fracture compared with 4.7% of those without one (P < .001).

Temporomandibular joint (TMJ) dislocation accompanied by a mandible fracture was associated with substantially greater hospital use among emergency department (ED) patients, according to findings presented at the 108th American Association of Oral and Maxillofacial Surgeons (AAOMS) Annual Meeting, Scientific Sessions and Exhibition.

TMJ dislocation is an uncommon ED presentation, and large-scale evidence describing affected patients, injury mechanisms, associated conditions, and health care utilization is limited. The investigators sought to characterize these factors among patients presenting to the ED with TMJ dislocation.

The researchers retrospectively analyzed ED encounters identified using ICD-10-CM diagnostic codes for TMJ dislocation (S03.0-). The analysis included 2,070 patients and assessed demographic and socioeconomic characteristics, injury features, ED charges, hospital admission, and interfacility transfer. The researchers compared continuous variables using Student t tests and categorical variables using chi-square tests, with statistical significance defined as P < .05.

Study Findings

The patients had a mean age of 42.4 years, and 1,192 (57.6%) were female. Bilateral dislocations occurred in 596 patients (28.8%), while 379 (18.3%) had right-sided dislocations and 437 (21.1%) had left-sided dislocations. Most dislocations were unintentional (73.2%); falls accounted for 10.8%, assaults for 4.3%, and motor vehicle accidents for 3.1%.

Overall, 186 patients (9.0%) had a concomitant mandible fracture. The mean ED charge was $6,641, and 254 patients (12.3%) were admitted. The abstract reported that 5% required transfer.

Females were older than males at presentation (44 vs 39.7 years; P < .001). Males had higher rates of concomitant mandible fracture (15% vs 4.5%), hospital admission (17.8% vs 8.2%), and interfacility transfer (9.2% vs 4.5%) than females (all P < .001). Mean ED charges were also higher among males ($7,993 vs $5,686; P < .001).

Among patients with a mandible fracture, 71% were male. Compared with patients without a fracture, those with a fracture had higher mean ED charges ($13,829 vs $6,005), admission rates (88.7% vs 4.7%), and transfer rates (50.5% vs 2.1%; all P < .001).

Clinical Implications

According to the researchers, recognizing demographic and injury patterns may help clinicians identify patients at greater risk for associated facial trauma and inform emergency-setting resource allocation. The findings also suggest that a concomitant mandible fracture identifies a subgroup with substantially greater use of hospital-level care. Since the analysis was retrospective, the results describe associations and do not establish causation.

Expert Commentary

“The presence of a mandibular fracture is associated with substantially increased healthcare utilization and a greater need for hospital-level care,” the researchers concluded.

Reference

Zoida J, Wu B, Karlis V, Bovino B. Patterns of injury and resource utilization in emergency department patients with temporomandibular joint dislocation. Abstract 70. Presented at: 108th American Association of Oral and Maxillofacial Surgeons Annual Meeting, Scientific Sessions and Exhibition (AAOMS 2026); October 1, 2026; Seattle, WA.