Distraction of the temporomandibular joint condyle in patients with unilateral non-reducing disc displacement: Fact or fiction?

Abstract

The findings of this study indicate that the TMJ condyle of patients with unilateral disc displacement without reduction may be unilaterally distracted if the articular space is narrowed.

The importance of using a specific diagnosis in evaluating and treating TMD

“…Greene and Menchel did not study the effectiveness of a unilateral pivot, which would be a Class 1 lever rather than the Class 3 lever described in these two references. I feel that unilateral pivots are supported in the literature [8] and are very effective in distracting the condyle to promote healing. Lateral Capsulitis: If distraction of the condyle and/or palpation of the lateral ligament reproduces the patient's chief complaint, the irritation of the lateral capsule could be caused by a distraction of the condyle due to an interference in the occlusion, which can be corrected by a minor equilibration.…”

“…This pivot appliance is the primary appliance I used on patients referred by the insurance company for screening before surgery; it was very effective, as very few patients actually needed surgery after this treatment. Although there have been no evidencebased studies showing the effectiveness of these unilateral pivots, there have been studies to support this [8], and clinical evidence and vector studies definitely support their use [9], although more evidence-based research needs to be done in this area. There is literature that shows that bilateral pivot appliances do not distract the condyle any differently than a stabilization appliance [10].…”

Effect of Disc Position for Acute Closed Lock of the Temporomandibular Joint

“…With respect to pivot sprints, Seedorf et al [22] report no distractive effect on the TMJ. In contrast, Yilidix et al [23] report that a pivot sprint has distractive effects on unilateral DD without reduction. Despite scant evidence for the results of pivot sprints, in our clinic, we instruct patients to wear a pivot sprint at night, in addition to performing passive exercises, based on the prospects of the dis-Open Journal of Stomatology tractive effects on TMJ.…”