Effects of four treatment strategies for temporomandibular joint closed lock

Schiffman, Eric L; Velly, Ana Míriam; Look, John O; Hodges, James S.; Swift, James Q.; Decker, K. L.; Anderson, Quentin; Templeton, R. B.; Lenton, Patricia A; Kang, Wenjun; Fricton, James R.

doi:10.1016/j.ijom.2013.07.744

Cited by 103 publications

(79 citation statements)

References 27 publications

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“…Schiffman et al recommended ibuprofen in a dose of 800 mg, 3 times per day up to 6 weeks of treatment [14]. Minakuchi et al used diclofenac sodium in doses of 25 mg, 3 times per day up to 8 weeks.…”

Section: Pharmacotherapymentioning

confidence: 99%

“…In cases of marked muscle tension muscle relaxants might be prescribed for the initial 1-2 weeks of treatment. The medication used can be cyclobenzaprine in dose of 10 mg, once a day, at bedtime [14].…”

Section: Pharmacotherapymentioning

confidence: 99%

“…The initially applied therapy should be minimally invasive. The surgical methods of treatment should be considered after 6 months of unsuccessful conservative management [13][14][15].…”

mentioning

confidence: 99%

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The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

Miernik¹,

Więckiewicz²

2015

Adv Clin Exp Med

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Temporomandibular joint derangement is a common disorder of the stomatognathic system. One type of these disorders is disc displacement without reduction with limited mouth opening, characterized by pain in affected TMJ and a decreased range of mouth opening. The natural course of closed lock is self-limiting. However, if there is no significant improvement after 12 weeks of following natural course of disc displacement without reduction, this is an indication that the therapy should be implemented. The article presents a review of the most commonly applied methods of basic conservative closed lock treatment. The most commonly applied methods of closed lock conservative management are: education and counseling, mandibular manipulation, splint therapy, exercise therapy and pharmacotherapy. The first choice method of treatment should be minimally invasive. The surgical management should be considered after unsuccessful conservative therapy. All presented methods of closed lock treatment seem to be effective in decreasing pain and reestablishing physiological range of motion (Adv Clin Exp Med 2015, 24, 4, 731-735).Key words: TMD, closed lock, conservative treatment. Internal derangement in temporomandibular joint (TMJ) is a common dysfunction of the stomatognathic system. According to classification of Research Diagnostic Criteria for TMD there are 3 main types of internal TMJ derangement: disc displacement with reduction and disc displacement without reduction with or without limited mouth opening. The prevalence of disc displacement is about 41% in TMD patients. The most common type is disc displacement with reduction characterized by clicking in the temporomandibular joint. In about 5% of cases the disc displacement without reduction with limited mouth opening is observed. The main symptoms of closed lock are pain in affected joint and decreased range of mouth opening (≤ 35 mm), which deteriorate the function of the stomatognathic system and force the patient to look for professional help [1][2][3]. REVIEWSThe symptoms of closed lock are usually related to disc displacement without reduction. The etiology of disc displacement is not clear, but there are a few possible reasons playing a key role in changes of the TMJ structure, such as parafunctions (e.g. bruxism), anatomical factors, trauma or general hypermobility of the joints [4][5][6][7]. In the majority of cases the disc is displaced anteriorly, blocking mechanically translating movement of the condyle, resulting in restricted mouth opening. In addition the bilaminar zone becomes overloaded by direct contact with the condyle, which is the main reason of pain in the TMJ [8].It has been stated that the natural course of disc displacement without reduction is self-limiting. Significant improvement of clinical symptoms of closed lock is observed in 75% of patients in a 2.5 year follow-up. The MRI scans reveal permanently displaced and deformed disc in untreated closed lock patients. The reduction of restriction of mouth opening and pain is most probably...

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Section: Pharmacotherapymentioning

confidence: 99%

Section: Pharmacotherapymentioning

confidence: 99%

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The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

Miernik¹,

Więckiewicz²

2015

Adv Clin Exp Med

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“…farmakolojik tedavi amacı ile 6 hafta boyunca günde üç kez 800mg ibuprofen kullanılma-sını önermişlerdir. 36 Minakuchi ve ark. 8 hafta boyunca günde üç kez 25mg diklofenak sodyum ve NSAİİ ile birlikte anti-gastrik ülser tedavisinin de gerekli olduğunu vurgulamışlardır.…”

Section: Farmakoterapi̇unclassified

Conservative Treatment Approaches of Temporomandibular Joint Disc Displacement Without Reduction

Yavuz¹,

Keskinruzgar²,

Kaya³

et al. 2019

Turkiye Klinikleri J Dental Sci

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Ö ÖZ ZE ET T Temporomandibular eklem düzensizlikleri, temporomandibular eklemde (TME), çiğneme kaslarında ve oral ve maksillofasiyal bölgenin diğer komponentlerinde patolojik ve fonksiyonel olarak değişikliklere sebep olan ve oldukça geniş bir alanı etkileyen klinik bir durumdur. Toplumda oldukça yüksek oranda görülen TME düzensizlikleri baş ve boyun bölgesinde ağrıya sebep olup hastaların hayat kalitesini düşürmektedir. Bu düzensizlik erken dönemde tedavi edilmediği takdirde ilerlemekte ve TME'de kalıcı hasarlara sebep olabilmektedir. Son yıllarda, modern toplumlarda psikolojik duyarlılıklardaki (stres gibi) artıştan dolayı TME düzensizlikleri bulunan hastaların sağlık kuruluşlarına başvurusunda artış görülmektedir. Temporomandibular eklem internal dü-zensizlikleri temporomandibular eklem düzensizliklerinin en sık karşılaşılaşılan formudur. İn-ternal düzensizliklerden TME'nin redüksiyonsuz disk deplasmanına da sıkça rastlanılmaktadır. Bu klinik durumda disk deplase olmuştur, kondil hareketleri kısıtlanmıştır ve etkilenen tarafta ağrı mevcuttur. Redüksiyonsuz disk deplasmanı için birçok tedavi yöntemi bildirilmiştir. Bu tedavi yöntemleri konservatif ve cerrahi tedaviler olmak üzere ikiye ayrılmıştır. Redüksiyonsuz disk deplasmanı tedavisinde en sık uygulanan konservatif tedavi yöntemleri: hasta eğitimi ve koruyucu tedavi, manuel manipulasyon, splint tedavisi, fizik tedavi ve ilaç tedavisidir. İlk tercih edilen tedavi seçeneği çoğunlukla konservatif tedavilerdir. Konservatif tedaviler ile cevap alınamayan hastalarda cerrahi tedavi seçenekleri tercih edilmektedir. Bu derlemede redüksi-yonsuz disk deplasmanı bulunan hastalarda uygulanabilecek konservatif tedavi metotlarından bahsedilecektir. Redüksiyonsuz disk deplasmanı tedavisinde sunulan tüm tedavi yöntemlerinin ağrıyı azaltmada ve fonksiyonel çene hareketlerinin tekrar kazanılmasında etkili olduğu düşü-nülmektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : TME; temporomandibular eklem bozuklukları; tedavi protokolleri A AB BS ST TR RA AC CT T Temporomandibular joint (TMJ) disorders are a group of conditions that cause pathological and functional changes in TMJ and muscles that control jaw movement. TMJ disorders are common. They cause pain in the head and neck region, and decreases patient quality of life. TMJ disorders need to be treated early as they can result in permanent damage to the TMJ if allowed to progress. Greater attention is being given to this group of disorders in modern times, owing to an increase in psychological conditions (i.e., stress). TMJ internal derangement is the most common form of TMJ disorders. TMJ disc displacement without reduction is also frequently encountered owing to internal irregularities. With TMJ disorders, the disc is displaced, condylar movement is restricted, and pain is present on the affected side. Several treatment methods, either conservative or involving surgery, have been reported for disc displacement without reduction. Conservative therapy constitutes the first-line approach and includes patient educati...

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“…Todos melhoraram significantemente a freqüência e intensidade da dor na ATM, amplitude de movimento mandibular, ruídos articulares e alterações na mastigação (Schiffman et al, 2014a).…”

Section: Tratamento Da Dtmunclassified

Efeito de exercícios motores orofaciais e laserterapia nos sintomas de desordem temporomandibular e funções orofaciais

Cusumano¹,

Felício²

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Effects of four treatment strategies for temporomandibular joint closed lock

Cited by 103 publications

References 27 publications

The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

Conservative Treatment Approaches of Temporomandibular Joint Disc Displacement Without Reduction

Efeito de exercícios motores orofaciais e laserterapia nos sintomas de desordem temporomandibular e funções orofaciais

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