Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction

Tatlı, Ufuk; Benlidayı, Mehmet Emre; Ekren, Orhun; Salimov, Fariz

doi:10.1016/j.ijom.2017.01.018

Cited by 58 publications

(46 citation statements)

References 28 publications

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“…In the present study, simultaneous unilateral arthrocentesis on more symptomatic TMJ and occlusal splints were used during 6 months to 44 patients for the management of bilateral ADDwoR with erosive change. Results of the present study are in agreement with those of other studies, showing significant improvement in mean VAS pain score for all clinical outcome variables in the arthrocentesis site compared to pre‐treatment clinical outcomes. ( P < .01).…”

Section: Discussionsupporting

confidence: 92%

“…The success rate of arthrocentesis mentioned in the literature ranges from 70% to 90% . With a high success rate, some authors have proposed that arthrocentesis can be used as first‐line treatment of internal derangement of the TMJ …”

Section: Discussionmentioning

confidence: 99%

“…It is generally suggested for patients who are unresponsive to conservative therapy . With a high success rate, arthrocentesis is now widely used in the treatment of internal derangement of the TMJ . Although arthrocentesis shows good treatment results by lavage of the upper joint space, the effectiveness of procedure is limited when patients have bruxism or clenching because arthrocentesis therapy alone cannot reduce mechanical stress directed to the TMJ or the intra‐articular pressure.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy

Heo

Yoon

2019

J of Oral Rehabilitation

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The efficacy of a combination treatment of arthrocentesis and stabilisation splint for patients with bilateral anterior disc displacement without reduction (ADDWoR) and erosive change of the TMJ remains controversial. To evaluate clinical outcomes of patients with ADDWoR and erosive change of the TMJ after performance of unilateral arthrocentesis and stabilisation splint therapy. A retrospective study of 44 patients (37 females, 7 males, mean age of 34 years) with bilateral ADDWoR and erosive change of the TMJ were included in this study. Their clinical outcomes before and after arthrocentesis and stabilisation splint therapy were compared. Evaluation criteria were as follows: (a) Maximal mouth opening (MMO); (b) Right and left maximal lateral movement (RLM, LLM) and maximal protrusive movement (PM); (c) Visual analog scale (VAS) pain score during MMO, RLM, LLM and PM; and (d) VAS pain score during palpation of masticatory muscles. Wilcoxon signed‐rank test, Mc Nemar test and paired t test were used for statistical analysis. Differences in VAS pain score between arthrocentesis and non‐arthrocentesis sites were not statistically significant except MMO and LLM (P < .05) after 6 months. Differences in mean VAS pain scores for all variables between before arthrocentesis and 6 months follow‐up in the arthrocentesis site were statistically significant. (P < .01). Unilateral arthrocentesis on more symptomatic TMJ and subsequent stabilisation splint therapy was highly successful for pain and achievement of normal range of mandibular movements in patients with both ADDWoR and bony change.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy

Heo

Yoon

2019

J of Oral Rehabilitation

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“…However, the predominantly used criteria were the RDC, 6 used in 17 studies. 11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27 The DC criteria 7 were used in two studies, 28,29 and an additional three studies used criteria that approximated to the RDC (either by citing the instrument and/or their description matched a similar process). 30,31,32 No studies used the AAOP criteria.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Oral splints for temporomandibular disorder or bruxism: a systematic review

et al. 2020

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This systematic review comprehensively summarised the best available evidence from randomised controlled trials on the effects of oral splints for temporomandibular disorders (TMD) and bruxism.There is no evidence to support the use of oral splints for either condition based on the results found.For TMD patients, sensitivity analyses were conducted to explore the effects of differences in: 1) diagnostic criteria; 2) splint types; and 3) outcome measures used and reported. There were no differences in the results based on these factors. AbstractObjectives To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism).Data sources Four databases including MEDLINE and EMBASE were searched from inception until 1 October 2018. Data selection and extractionRandomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome of pain, using random effects models in TMD patients. Data synthesisThirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all subtypes of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1,076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome. No trials measured tooth wear in patients with bruxism. There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain. ConclusionsThe very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.

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“…Ghanem et al reported better results with stabilisation splints and arthrocentesis in acute closed lock patients. While Alpaslan et al and Tatli et al report no additional effect of stabilisation splints as compared to arthrocentesis alone. Of the 4 trials in this review, Senturk et al have reported the use of stabilisation splints in the post‐operative period.…”

Section: Discussionmentioning

confidence: 95%

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Nagori¹,

Chowdhury

Thukral³

et al. 2018

J of Oral Rehabilitation

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The aim of this systematic review was to investigate the current evidence in order to assess the efficacy of single puncture arthrocentesis vs standard double needle arthrocentesis in the management of temporomandibular joint(TMJ) disorders. An electronic search of the PubMed, Scopus, Cochrane CENTRAL and Google Scholar databases was performed to identify English studies published up until October 2017. Eligible studies were selected based on inclusion criteria and included randomised controlled trials(RCTs) comparing single puncture arthrocentesis and standard double needle arthrocentesis for the management TMJ disorders. The initial screening identified 984 records, of which only 5 fulfilled the inclusion criteria. A high degree of heterogeneity was found in the 5 studies with each reporting different sample selection and arthrocentesis protocol. All 5 studies reported no difference in reduction in pain intensity and improvement in maximal mouth opening between the single puncture technique and standard double needle technique. This review provides some evidence that single puncture arthrocentesis is clinically as efficacious as standard double needle arthrocentesis. There is a need of well-designed RCT with standard protocol of arthrocentesis comparing different single puncture techniques and standard double needle technique for the management of TMJ disorders.

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Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction

Cited by 58 publications

References 28 publications

Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy

Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy

Oral splints for temporomandibular disorder or bruxism: a systematic review

Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

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