Randomized Clinical Trial of Treatment for TMJ Disc Displacement

Abstract

Of the various conservative treatment modalities available for temporomandibular disorders, we believe that therapeutic exercise has a good prognosis, especially for anterior disc displacement without reduction. Since its effectiveness has not been extensively evaluated, we conducted a comparative study to verify the hypothesis that treatment efficacy would not differ for exercise and occlusal splints. Fifty-two individuals with anterior disc displacement without reduction were randomly assigned to a splint or a joint mobilization self-exercise treatment group. Four outcome variables were evaluated: (i) maximum mouth-opening range without and (ii) with pain, (iii) current maximum daily pain intensity, and (iv) limitation of daily functions. All outcome variables significantly improved after 8 weeks of treatment in both groups. In particular, the mouth opening range increased more in the exercise group than in the splint group. This result demonstrates that therapeutic exercise brings earlier recovery of jaw function compared with splints.

Asymmetric severe skeletal Class II division 1 patient with temporomandibular joint disorder treated with zygomatic anchorage devices and Ni-Ti alloy wires

“…Moreover, we instructed her to perform manual jaw-opening exercises by herself, according to the previous report. 26 Two months later, TCH and TMD pain disappeared. In the current case, the mandibular jaw position was relocated backward approximately 3.0 mm compared with the initial position.…”

Conservative Treatment Approaches of Temporomandibular Joint Disc Displacement Without Reduction

“…Stabilizasyon splintinin kapalı kilitli hastalarda semptomları önemli derecede azalttığını bildiren çalışmalar olduğu gibi semptomların çok az iyileş-tiğini belirten çalışmada bulunmaktadır. [20][21][22] Kai ve ark. redüksiyonsuz disk deplasmanlı vakalarda stabilizasyon splinti kullanımı ile klinik semptomların azaldığını fakat radyolojik olarak osteoartritik değişikliklerin arttığını göstermişlerdir.…”

“…yaptıkları çalışmada benzer esneme egzersiz programını uygulamışlardır. 20 Kapalı kilitlenme bulunan hastalar manuel çene açma egzersizini 8 hafta boyunca günde 4 kez yapmışlar-dır. Tek seans 3 esneme devresi içermekte ve her devre 30 saniye sürmektedir.…”

Assessment of Occlusal Appliance in Repositioning of the Temporomandibular Joint Anterior Disc Displacement With Reduction: A 3 to 36 Months Follow-Up

“…T. Haketa и соавт. по результатам рандо-мизированного клинического исследования при-шли к следующему заключению: симптомы пато-логии ВНЧС одинаково устраняются с помощью физических упражнений и окклюзионных шин [7]. Таким образом, многочисленные публикации подтвердили, что окклюзионные сплинт-системы могут в той или иной степени уменьшить клини-ческую симптоматику переднего вывиха диска ВНЧС.…”