engleski

Mandibular range of motion and pain intensity in patients with temporomandibular joint disc displacement without reduction

Primary goal in the treatment of temporomandibular joint disc displacement without reduction is to ease pain and to regain mandibular function despite of disrupted anatomical relationship between TMJ structures. The aim of this study was to evaluate the effectiveness of the simultaneous application of physical therapy and stabilization splint on mandibular range of motion and pain intensity in patients with anterior disc displacement without reduction in a 6-month treatment period. Twelve patients (mean age =30.5 y) with anterior disc displacement without reduction (according to RDC/TMD and confirmed by magnetic resonance imaging) were randomly allocated into 2 groups: 6 received stabilization splint only (SS) and 6 received both physical therapy and stabilization splint (SS&PT). Treatment outcomes included pain- free maximal mouth opening (MO), assisted maximal MO, path of MO, asymmetry in lateral excursions and pain as reported on visual analogue scale (VAS). At baseline of treatment there were no significant differences among the groups for VAS scores, as well as for the range of mandibular motion. VAS scores improved significantly across time for the SS&PT group (F=28.964, p=0.0001, effect size =0.853) and SS group (F=8.794, p=0.001, effect size =0.638). Pain-free MO improved significantly only in the SS&PT group (F=20.971, p=0.006, effect size =0.807). Changes in path of MO differ significantly between groups (p=0.040). Only one patient in SS&PT group and 5 patients in SS group still presented deviations in mouth opening after completed therapy. The results of this limited study revealed that during 6-month treatment period stabilization splint combined with physical therapy was more effective than stabilization splint delivered without physical therapy in improving pain-free MO and reducing deviations during mouth opening. Both treatment modalities were effective in reducing pain in patients with anterior disc displacement without reduction. Physiological function was restored in spite of objectively diagnosed disruption of functional temporomandibular anatomy.

temporomandibular joint ; functional anatomy ; anterior disc displacement

nije evidentirano