To illustrate cases of oromandibular dystonia (OMD) misdiagnosed due to long-standing condylar dislocation and to highlight the need for diagnostic reassessment in such cases.
Approach:
Case Presentation: Two patients initially diagnosed with OMD underwent botulinum toxin injections without benefit, later found to have long-standing condylar dislocation.
Diagnostic Evaluation: Both cases involved comprehensive dental and oral/maxillofacial evaluations, including panoramic radiography.
Key Findings:
Both patients showed no improvement from botulinum toxin injections.
Panoramic radiography revealed long-standing condylar dislocation as the primary diagnosis.
Patients improved after structural correction and prosthetic rehabilitation.
Interpretation:
Botulinum toxin non-response should prompt a systematic reassessment for structural disorders in patients with suspected OMD.
Limitations:
The cases do not represent the frequency or full clinical spectrum of structural mimics among patients with suspected OMD, and selection bias may affect the generalizability of the findings.
Conclusion:
The findings highlight the importance of considering structural disorders in patients with OMD-like symptoms who do not respond to botulinum toxin therapy.
