Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation

Abstract

Disc displacement with reduction (DDWR) is one of the most common intra-articular disorders of the temporomandibular joint (TMJ). Factors related to the etiology, progression and treatment of such condition is still a subject of discussion. This literature review aimed to address etiology, development, related factors, diagnosis, natural course, and treatment of DDWR. A non-systematic search was conducted within PubMed, Scopus, SciELO, Medline, LILACS and Science Direct using the Medical Subjective Headings (MeSH) terms “temporomandibular disorders”, “temporomandibular joint”, “disc displacement” and “disc displacement with reduction”. No time restriction was applied. Literature reviews, systematic reviews, meta-analysis and clinical trials were included. DDWR is usually asymptomatic and requires no treatment, since the TMJ structures adapt very well and painlessly to different disc positions. Yet, long-term studies have shown the favorable progression of this condition, with no pain and/or jaw locking occurring in most of the patients.

Somatosensory and psychosocial profile of patients with painful temporomandibular joint clicking

“…DDWR is probably the most common cause of TMJ clicking, defined as a sound event that occurs when the disc is displaced and repositioned during mandibular movements 3‐5 . Although TMJ clicking is usually painless, some patients can present concomitant joint pain that happens or is intensified at the opening clicking moment, possibly due to compression of the bilaminar zone and TMJ inflammation, characterising a painful TMJ clicking 3,4,6 . Arthralgia is the inflammation of the joint capsule and/or of the TMJ synovial lining, generating pain that is affected by jaw movement, function, or parafunction, and the replication of this pain occurs with provocation testing of the TMJ 3,6 …”

Validação do protocolo de avaliação miofuncional orofacial MBGR para adultos com disfunção temporomandibular com deslocamento de disco com redução

“…Furthermore, one of the inclusion criteria for the SG was to present a specific diagnosis of TMD with disc displacement with reduction (DDWR). This type of TMD has been considered a common and asymptomatic condition that generally does not require treatment, considering that the structures of this region can adapt, and progression is benign in most cases (28) . This feature of DDWR added to the low symptomatology of the study participants could also justify the absence of difference between the groups with respect to OMD.…”

Anterior repositioning splint treatment consideration for cases of disc displacement with reduction

“…A recent publications show 31% of patients has no signs of painful condition. 2 Correlation between pain and TMD is still a matter of debate. Okeson explained that intracapsular disorder can occur on patients with orthopedically unstable TMJ as well as unfavorable masticatory force.…”

“…A literature review is important to determine whether DDWR treatment will be needed and/or the degree of treatment that can be provided for patient. 2 The use of anterior repositioning splint (ARS) has been known as one of the treatment alternatives for DDWR with a good success rate. A shortterm use of ARS has been shown to be able to reduce painful symptom associated with DDWR.…”