[Purpose] This study investigated the effectiveness of a short-term exercise program
combining range-of-motion exercise for the temporomandibular joint and self-traction
therapy in patients with temporomandibular joint disc displacement without reduction.
[Subjects and Methods] The study participants comprised 36 females with jaw trismus and
moderate to severe functional pain. The range-of-motion exercise for the temporomandibular
joint was performed at the first visit by the therapist, and the patients were instructed
to perform self-traction therapy in the morning and during daily bathing until the next
visit 2 weeks later. Maximum mouth opening distance and the visual analogue scale score
were used to compare pain on motion and mastication as well as the impact of the program
on daily activities at the first consultation and 2 weeks later. [Results] All symptoms
were significantly improved after 2 weeks of treatment. [Conclusion] A program that
combines exercise for the temporomandibular joint and self-traction therapy can improve
range of motion at the joint in the short term and reduce pain and difficulty associated
with daily activity in patients with temporomandibular joint disc displacement without
reduction. The results of this study suggest that such a program can serve as an effective
conservative treatment.
Abstract:The ultrastructure of the articular fibrous zone of the rat mandibular condyle was observed at 3 and 6 weeks of age in order to investigate the histological changes that occur during the establishment of mastication after suckling. We divided the articular fibrous zone into two layers (F1 layer and F2 layer). The F1 layer was composed of fibroblast-like cells, macrophage-like cells, and the matrix which consisted of granular or fibrilar material, loosely arranged small bundles of collagen fibrils with uniform thickness of 30-50 nm, and independent microfibrils. The F1 layer was continuous with the synovial membrane without any distinct boundary in its peripheral area. Mitotic figures could infrequently be observed in the fibroblast-like cells. The cells in the F2 layer closely resembled fibroblasts. The matrix in the F2 layer mostly consisted of densely arranged bundles of collagen fibrils which are not of uniform diameter ranging 40-100 nm. Elastic fibers occurred among the collagen fibrils. The F1 layer which was observed clearly at 3 weeks almost disappeared at 6 weeks of age. It is confirmed that the F1 layer resembling the synovial membrane exists over the condyle up to the weaning period about 3 weeks of age but it degenerates before 6 weeks of age when the masticatory function is established.
Abstract:In the mandibular condyle of young rats , strontium rickets was induced by a diet in which 2.2 % SrCO3 was substituted for calcium salt in a standard diet . The main morphological changes which were characteristic of strontium rickets were a small condyle , an enlarged ramus, an expansion of the hypertrophic cell zone , and the formation of osteoid tissue.
[Purpose] The efficacy of exercise therapy in temporomandibular disorders has been
recognized. Here, we present our experience with exercise therapy. [Participant and
Methods] A 25-year-old female with a sudden onset of mouth opening limitation in October
2018 was admitted to our hospital in November 2018. Based on our initial findings, the
patient was diagnosed with left disc derangement of the temporomandibular joint without
reduction. A definitive diagnosis was established following magnetic resonance imaging in
December 2018. Subsequently, range-of-motion exercises for the temporomandibular joint as
passive movements and self-traction therapy as active movements were conducted. Magnetic
resonance imaging was repeated 4 months after the first treatment. [Results] The
temporomandibular joint disc remained in anterior dislocation during mouth opening and
closing. The mouth opening joint motion was significantly improved compared to the
pre-therapy range. The pain-related visual analog scale score also significantly improved.
[Conclusion] The range of motion of the temporomandibular joint was improved by
range-of-motion exercises for the temporomandibular joint, and was maintained and managed
using self-traction therapy. Improvement of the range of motion was confirmed by magnetic
resonance imaging.
Background: Exercise therapy is occasionally considered as an initial treatment for temporomandibular disorders. However, pain can be exacerbated during exercise therapy.Objective: To investigate the immediate curative effects of exercise therapy in patients with masticatory muscle myalgia.Methods: Fifty-nine patients with masticatory muscle myalgia were included.Therapists performed exercise therapy (stretched the painful masseter and/or cervical muscles along the direction of muscle contraction) in 10 rounds of traction, each lasting 10 s. The patient's pain-free maximum mouth opening distance and degree of pain (VAS value) before and immediately after exercise therapy were compared using the Wilcoxon signed-rank test. The Mann-Whitney U test was used for the subgroup comparisons.Results: Mouth opening increased from 41 to 46 (IQR 43-48) mm and pain alleviation from 48 (IQR 31-56) to 21 (IQR 10-56) immediately following exercise therapy (p < .001 for both). None of the patients experienced pain exacerbation or reduction in mouth opening post-exercise. No difference in mouth opening distance changes according to sex, painful side, painful site and therapist were observed (p > .05 for all). Pain reduction was greater in patients with unilateral pain (26, IQR 12-39) than those with bilateral (13, IQR 5-25) (p = .019). There were no differences in the change in the degree of pain according to sex, painful site and therapist (p > .05 for all).
Conclusion:Exercise therapy immediately enlarged the mouth opening distance and reduced myalgia; therefore, it could be helpful in managing masticatory muscle myalgia.
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