Randomized Controlled Evaluation of Non-surgical Treatments for Temporomandibular Joint Anterior Disk Displacement without Reduction

Minakuchi, Hajime; Kuboki, Takuo; Matsuka, Yoshizo; Maekawa, Kenji; Yatani, Hirofumi; Yamashita, Atsushi

doi:10.1177/00220345010800031501

Cited by 99 publications

(57 citation statements)

References 10 publications

(7 reference statements)

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“…Protrusion of the mandible may decrease overload on the retrodiscal tissues, allowing adaptive changes to occur. Several studies have revealed the short-term efficacy of this modality for reducing TMD symptoms (10)(11)(12)(13)(14), in agreement with our present results.…”

Section: Discussionsupporting

confidence: 93%

Comparison of three treatment options for painful temporomandibular joint clicking

Madani

Mirmortazavi

2011

J Oral Sci

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A randomized clinical trial wasperformed to evaluate the efficacy of three treatment options, including anterior positioning splint therapy, physical therapy, and physical therapy in addition to splint therapy, in terms of treatment outcome, in patients with painful temporomandibular joint clicking. Sixty patients suffering from acute pain and dysfunction were divided randomly into three treatment groups. Twenty patients underwent anterior positioning splint therapy (group I), 20 patients received solely physical therapy (group II), and 20 subjects received physical treatment in addition to splinting (group III). All patients were examined before and after the treatment using a visual analogue scale (VAS) and digital palpation of joint sounds. The data were analyzed using the Kruskal-Wallis, one-way ANOVA and Tukey tests at a significance level of P < 0.05. In comparison with the baseline, subjective pain was decreased significantly (P < 0.05) in all three groups. A significant difference was observed between groups I and II (P <0.05), whereas no significant difference was detected between groups II and III. Six patients in group III did not continue the treatment after physical therapy. The numbers of pain-free patients were 12 in group I, 5 in group II and 9 in group III. We observed a reduction in the frequency of joint sounds across the entire sample (P < 0.05). Anterior positioning splint therapy appears to be the best treatment method for reduction of pain and joint sounds in patients with TMD, compared with the other two methods studied. (J Oral Sci 53, 349-354, 2011)

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Section: Discussionsupporting

confidence: 93%

Comparison of three treatment options for painful temporomandibular joint clicking

Madani

Mirmortazavi

2011

J Oral Sci

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“…Results of our study agree with various studies supporting the usefullness of occlusal splints in the management of TMJ dysfunction syndrome. [5,[16][17][18] But, our results showed that TrP injection combined with SS therapy was more effective in the treatment of myofascial TMD pain for signs and symptoms improvement. Naikmasur, et al (2008) and Suvinen and Reade (1989) have also shown 10.02 mm and 7.4 mm increase in MIO after splint therapy in MPDS patients.…”

Section: Discussionmentioning

confidence: 72%

Trigger point injection therapy in the management of myofascial temporomandibular pain

Özkan

Özkan²,

Erkorkmaz³

2011

Agri

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SummaryObjectives: Myofascial pain is the most common temporomandibular disorder. The objective of this study was to compare the effectiveness of combined treatment modalities in the management of myofascial temporomandibular pain. Methods:Fifty patients (44 female, 6 male) clinically and radiologically diagnosed with myofascial temporomandibular disorder (TMD) were selected for the study and randomly assigned to two groups of 25 patients. Group 1 patients were treated with stabilization splint (SS) and Group 2 patients were treated with trigger point injection combined with SS therapy.Results: Positive improvement in overall signs and symptoms with statistically significant differences was observed in both groups. Group 2 showed significant reduction in visual analogue scale (VAS) scores, and statistical analysis revealed a significant difference between the VAS scores of Group 1 and Group 2 at the 4th and 12th weeks of treatment follow-up (p<0.001). Conclusion:Our results indicate that trigger point injection therapy combined with splint therapy is effective in the management of myofascial TMD pain. Further research, especially randomized controlled trials, should be carried out to ascertain its effectiveness over other treatment modalities.

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“…The recommended self-care protocol might include thermotherapy (cold or warm packs), soft food diet and gentle mouth-opening exercises in the initial period of locking. According to Minakuchi et al and Craane et al there is no significant difference in outcomes of self-care protocol, pharmacotherapy, splint therapy vs. no treatment, which might indicate that conducting treatment in closed lock patients is not necessary [16,17].…”

Section: Conservative Therapy Of Closed Lock Education and Counselingmentioning

confidence: 98%

“…Minakuchi et al used diclofenac sodium in doses of 25 mg, 3 times per day up to 8 weeks. Moreover, Minakuchi et al emphasized the need of an anti-gastric ulcer medication during NSAIDS therapy [16]. In cases of marked muscle tension muscle relaxants might be prescribed for the initial 1-2 weeks of treatment.…”

Section: Pharmacotherapymentioning

confidence: 99%

The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

Miernik¹,

Więckiewicz²

2015

Adv Clin Exp Med

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Temporomandibular joint derangement is a common disorder of the stomatognathic system. One type of these disorders is disc displacement without reduction with limited mouth opening, characterized by pain in affected TMJ and a decreased range of mouth opening. The natural course of closed lock is self-limiting. However, if there is no significant improvement after 12 weeks of following natural course of disc displacement without reduction, this is an indication that the therapy should be implemented. The article presents a review of the most commonly applied methods of basic conservative closed lock treatment. The most commonly applied methods of closed lock conservative management are: education and counseling, mandibular manipulation, splint therapy, exercise therapy and pharmacotherapy. The first choice method of treatment should be minimally invasive. The surgical management should be considered after unsuccessful conservative therapy. All presented methods of closed lock treatment seem to be effective in decreasing pain and reestablishing physiological range of motion (Adv Clin Exp Med 2015, 24, 4, 731-735).Key words: TMD, closed lock, conservative treatment. Internal derangement in temporomandibular joint (TMJ) is a common dysfunction of the stomatognathic system. According to classification of Research Diagnostic Criteria for TMD there are 3 main types of internal TMJ derangement: disc displacement with reduction and disc displacement without reduction with or without limited mouth opening. The prevalence of disc displacement is about 41% in TMD patients. The most common type is disc displacement with reduction characterized by clicking in the temporomandibular joint. In about 5% of cases the disc displacement without reduction with limited mouth opening is observed. The main symptoms of closed lock are pain in affected joint and decreased range of mouth opening (≤ 35 mm), which deteriorate the function of the stomatognathic system and force the patient to look for professional help [1][2][3]. REVIEWSThe symptoms of closed lock are usually related to disc displacement without reduction. The etiology of disc displacement is not clear, but there are a few possible reasons playing a key role in changes of the TMJ structure, such as parafunctions (e.g. bruxism), anatomical factors, trauma or general hypermobility of the joints [4][5][6][7]. In the majority of cases the disc is displaced anteriorly, blocking mechanically translating movement of the condyle, resulting in restricted mouth opening. In addition the bilaminar zone becomes overloaded by direct contact with the condyle, which is the main reason of pain in the TMJ [8].It has been stated that the natural course of disc displacement without reduction is self-limiting. Significant improvement of clinical symptoms of closed lock is observed in 75% of patients in a 2.5 year follow-up. The MRI scans reveal permanently displaced and deformed disc in untreated closed lock patients. The reduction of restriction of mouth opening and pain is most probably...

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Randomized Controlled Evaluation of Non-surgical Treatments for Temporomandibular Joint Anterior Disk Displacement without Reduction

Cited by 99 publications

References 10 publications

Comparison of three treatment options for painful temporomandibular joint clicking

Comparison of three treatment options for painful temporomandibular joint clicking

Trigger point injection therapy in the management of myofascial temporomandibular pain

The Basic Conservative Treatment of TMJ Anterior Disc Displacement Without Reduction - Review

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