Simple Manipulation Therapy for Temporomandibular joint Internal Derangement with Closed Lock

Intra-oral manipulations, particularly thumb pressure techniques, were effective for closed-lock conditions, yielding notable clinical improvements.

“Intra-oral manipulations, particularly thumb pressure techniques, were effective for closed-lock conditions, yielding notable clinical improvements [38].”

Yoshida et al. used intraoral manipulation to treat TMJ internal derangements with 'closed locking,' demonstrating clinical efficacy.

“For example, Yoshida et al. [38] used intraoral manipulation to treat TMJ internal derangements with ‘closed locking,’ demonstrating clinical efficacy.”

In the study of Kropmans et al., a minimum increase of 5 mm in the opening after treatment was reported to be clinically important, especially for maximum mouth openings <35 mm before treatment.

“In the study of Kropmans et al., a minimum increase of 5 mm in the opening after treatment was reported to be clinically important, especially for maximum mouth openings <35 mm before treatment [35].”

An increase >3 mm is recognized as a remarkable improvement for maximum mouth opening ranging from 40 mm to 50 mm.

“However, an increase >3 mm is recognized as a remarkable improvement for maximum mouth opening ranging from 40 mm to 50 mm [35].”

Five of these studies favored the use of MT in conjunction with exercises compared with splints or with medications or other nonconservative treatments for arthrogenous TMD, such as arthroscopy and arthroplasty.

“Five of these studies 69,78,87,88,91 favored the use of MT in conjunction with exercises compared with splints 69,87,88 or with medications 91 or other nonconservative treatments for arthrogenous TMD, such as arthroscopy and arthroplasty.78”

In general, MT plus exercises reduced symptoms and increased ROM for patients with arthrogenous TMD, particularly for those with reduced ROM due to disk displacements without reduction (closed lock).

“In general, we found that MT plus exercises reduced symptoms and increased ROM for patients with arthrogenous TMD, particularly for those with reduced ROM due to disk displacements without reduction (”