Promising minimally invasive treatment modalities for symptomatic temporomandibular joint disc displacement with reduction: a randomized controlled clinical trial

Abstract

Background Pain and clicking are the primary complaints in patients suffering from temporomandibular joint disc displacement with reduction (DDwR), negatively affecting the patients' quality of life, making the treatment essential. This prospective randomized controlled trial (RCT) was conducted to evaluate the effectiveness of botulinum toxin type-A (BTX-A) and low level laser therapy (LLLT) in comparison to anterior repositioning appliance (ARA) for the treatment of DDwR. Methods A total of 27 patients were randomly allocated to 3 groups; ARA (control group), BTX-A, and LLLT; with 9 patients each. All patients were evaluated before and 3 months after the treatment using a visual analogue scale (VAS) and magnetic resonance imaging (MRI). Results At 3 months follow-up, all groups showed a significant reduction in pain assessed by VAS (P = 0.007). Measured on MRI, there was a significant improvement in disc position and joint space index (JSI) in BTX-A group (P < 0.001, P = 0.011) and LLLT group (P = 0.002, P = 0.017) in comparison to the control group (P = 0.087, P = 0.066) respectively. As for time of recovery, a statistically significant difference was observed in BTX-A group (P < 0.001) and LLLT (P < 0.001) group in comparison to ARA group, which showed the most prolonged duration for reduction of DDwR symptoms. Conclusion We concluded that BTX-A and LLLT could be considered effective alternative treatment modalities to ARA regarding reducing joint pain, clicking, and improving disc position in patients with symptomatic DDwR. Trial registration This prospective double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05194488, 18/1/2022.

Mental health and jaw function of patients with anterior disc displacement with reduction

“…When compared with non‐TMD participants in this study, patients with ADDWR suffered from a certain degree of pain and limited function without much negative emotional interference (anxiety and depression), which means professionals need to provide appropriate treatment. The treatment for ADDWR varies including, conservative, non‐surgical treatment focusing on alleviating pain, improving mouth opening, or recapturing the disc 26–29 . The appropriateness of ADDWR treatment is worth exploring, specifically, whether patients with ADDWR who visit a doctor receive adequate medical treatment or should be treated further.…”

A Bibliometric Analysis of Research on Temporomandibular Joint Disc Displacement from 1992 to 2022

“…In DDwR, which holds the higher frequency, there exists an abnormal disc-condyle relationship [11]. The displaced disc returns to the normal position on mouth opening, thereby producing Healthcare 2023, 11, 2108 2 of 15 a reciprocal click [12]. In DDwoR, the disc remains displaced in relation to the condyle, whether the mouth is open or closed [13].…”