Objective
This study compared clinical and magnetic resonance imaging (MRI) findings in patients
with anterior disk displacement without reduction (ADDWOR) who improved to anterior
disk displacement with reduction (ADDWR) vs. patients who did not improve after mandibular
manipulation (MM) and conservative self-administered physical therapy (CSAPT).
Study Design
Of 15 patients diagnosed with ADDWOR by MRI, 7 improved to ADDWR (WOR-WR) and 8 did
not improve (WOR-WOR). The clinical and MRI findings before and after therapy were
compared in each group.
Results
Significant differences between the groups included age, period of awareness of trismus,
and maximum mouth opening (MMO). The MRI findings revealed significant differences
in the degree of ADD and morphology of the disk and condyle. MMO significantly improved
in the WOR-WR group between initial and follow-up visits.
Conclusion
Patients who were successfully treated with MM and CSAPT tended to be <30 years old,
with a longer period of awareness of trismus, MMO <40 mm, a slight or moderate degree
of ADD, no deformity of the disk, and no morphologic change in the condyle. Patients
with ADDWOR who are treated with MM and CSAPT require an accurate clinical examination
and MRI before treatment.
Abbreviations:
TMD (Temporomandibular disorder), MRI (Magnetic resonance imaging), TMJ (Temporomandibular joint), ADDWR (Anterior disk displacement with reduction), ADDWOR (Anterior disk displacement without reduction)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders.Dentomaxillofac Radiol. 2018; 4720170412
- Association of temporomandibular joint pain according to magnetic resonance imaging findings in temporomandibular disorder patients.J Oral Maxillofac Surg. 2017; 75: 1848-1855
The Japanese Temporomandibular Joint Society, ed. Guidelines for the Treatment of Temporomandibular Disorders 2020. December 2020 (in Japanese). Available at: http://www.kokuhoken.net›publication›file›guideline. (accessed 2022-03-23)
AADR TMD Policy Statement Revision, approved by AADR Council (2010). Available at: http://www.aadronline.org/i4a/pages/index.cfm?pageid=3465. (accessed 2021-09-09)
- Structural hard-tissue changes in temporomandibular joints with internal derangement.Oral Surg Oral Med Oral Pathol. 1985; 59: 220-224
- The prevalence of osteoarthrosis in cases of advanced internal derangement of the temporomandibular joint: a clinical, surgical and histological study.Int J Oral Maxillofac Surg. 2005; 34: 345-349
- . Degenerative temporomandibular joint changes associated with recent-onset disk displacement without reduction in adolescents and young adults.J Craniomaxillofac Surg. 2017; 45: 408-413
- Temporomandibular joint: relationship between MR evidence of effusion and the presence of pain and disk displacement.AJR Am J Roentgenol. 1992; 159: 559-563
- MR image assessment of disk configuration and degree of anterior disk displacement in internal derangement related to age.Dental Radiol. 1999; 39: 20-26
- MR grading of temporomandibular joint fluid: association with disk displacement categories, condyle marrow abnormalities and pain.Int J Oral Maxillofac Surg. 2001; 30: 104-112
- Influence of psychosocial factors and habitual behavior in temporomandibular disorder-related symptoms in a working population in Japan.Open Dent J. 2012; 6: 240-247
- Biomechanical effect of resting the cheek on the hand to mandible and temporomandibular joint.Orthod Waves-Jpn Ed. 2008; 67 (Available at): 35-45
- 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behav Res Methods. 2007; 39 (Available at) (Accessed on February 28, 2022): 175-191
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- The basic conservative treatment of temporomandibular joint anterior disk displacement without reduction—review.Adv Clin Exp Med. 2015; 24: 731-735
- TMJ disk displacement without reduction management: a systematic review.J Dent Res. 2014; 93: 37S-51S
- Randomized effectiveness study of four therapeutic strategies for TMJ closed lock.J Dent Res. 2007; 86: 58-63
- Magnetic resonance image findings on reposition articular disk at opened mouth after treatment: case of disk position changes from anterior disk displacement without reduction to with reduction.J Jpn Soc TMJ. 2007; 19: 164-170
- Clinical indications of disk reduction therapy in a patient with acute anterior disk displacement without reduction of the temporomandibular joint.J Jpn Soc TMJ. 2015; 27: 93-102
- Relationship between disk position and degenerative bone changes in temporomandibular joints of young subjects with TMD. An MRI study.J Clin Pediatr Dent. 2014; 38: 269-276
- Prevalence of degenerative disease in temporomandibular disorder patients with disk displacement: a systematic review and meta-analysis.J Craniomaxillofac Surg. 2020; 48: 942-955
- Evaluation of temporomandibular joint disk displacement as a risk factor for osteoarthrosis.Int J Oral Maxillofac Surg. 2016; 45: 313-317
- Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings.J Craniomaxillofac Surg. 2012; 40: 283-286
- Disk position and the bilaminar zone of the temporomandibular joint in asymptomatic young individuals by magnetic resonance imaging.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94: 372-378
- Risk of temporomandibular joint effusion related to magnetic resonance imaging signs of disk displacement.Med Oral Pathol Oral Cir Bucal. 2009; 14: E188-E193
- Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD consortium network and orofacial pain special interest group.J Oral Facial Pain Headache. 2014; 28: 6-27
Article info
Publication history
Published online: September 16, 2022
Accepted:
September 5,
2022
Received in revised form:
August 26,
2022
Received:
March 22,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
