 Subluxation or hypermobility of the temporomandibular joint is the result of a relaxation of the ligaments of the joint following the loss of tissue tone or following a traumatic episode. Prolonged chronic trauma may also produce this condition. The joint of the mandibular condyles is actually a partial dislocation, which in the majority of instances is self-reducing. If this hypermobility is not corrected, the range of movement may progress until complete dislocation results requiring manual reduction. Hypermobility may also produce an acute inflammatory reaction in the region of the tissues of the temporomandibular joint. Therefore, it is considered advisable in many instances to correct the hypermobility before these complications occur. A simple means of treatment is to produce a sclerosis of the tissues of the joint which results in a limitation of joint movements. This film demonstrates a method of treatment of subluxation. The patient was first seen with an acute painful temporomandibular joint. This acute phase was managed by rest, heat, diathermy, and limited diet, with definitive treatment being withheld until complete resolution of the inflammatory reaction. A functional analysis of the occlusion was then carried out to detect any occlusal disharmonies which may affect the function of the temporomandibular joint. A prematurity in centric relationship is detected, causing the mandible to slide forward and slightly to one side as it seeks maximum intercuspation. The hypermobility and the patient's ability to reduce the partial dislocation are quite obvious. After occlusal equilibration has been accomplished, the sliding movement of the mandible has been eliminated, and centric occlusion and centric relationship now coincide. The excursive movements are now also checked, and any gross disharmony is corrected. The occlusion is again analyzed functionally, and the opening and closing movements are studied. The armamentarium for producing a sclerosis of this tissue consists of an aspirating syringe, a sclerosing solution, and a local anesthetic. Several sclerosing solutions, such as silnesol or unicane in oil, may be used. In this instance, silnesol is being used. The injection site is thoroughly cleansed with a suitable detergent and a sterile field maintained throughout the procedure. The articular fossa is located by palpation, while the patient is opening the mouth to its maximum extent. Local anesthetic solution is injected into the region. Aspiration is an important feature of this technique, for it is inadvisable to inject the anesthetic solution or sclerosing agent directly into the bloodstream. If blood is aspirated, such as you see here, the needle is withdrawn and reinserted in a slightly different direction. Approximately one cc of the anesthetic solution is deposited in the articular fossa. Without withdrawing the needle, the syringe containing the anesthetic solution is detached, and another syringe containing the sclerosing solution is attached. One half cc of silnesol is deposited directly into the articular fossa. The same procedure is repeated on the opposite side. A moderate to severe soft tissue reaction manifested by swelling, pain, and limitation of movement of the jaw is to be expected as the result of the injection. This reaction is self-limiting in nature and usually resolves in 10 to 14 days. The desired amount of sclerosing solution is often not obtained from one injection, and it is frequently necessary to re-inject the sclerosing solution from two to four times. If repeated injections are necessary, a minimum of two weeks should elapse between the injections. The rent genograms show the abnormal position of the condyles that existed before treatment, and the improved position that resulted from the described therapy. The top view shows the condyle positions before treatment and the lower after treatment. The condyle positions on the opposite side are shown in a similar manner. The patient is seen here several weeks after the second injection, and the movements permitted, studied, and the occlusion checked. No further injections were deemed necessary as the desired limitation of movement has now been attained.