Randomized Clinical Trial of Treatment for TMJ Disc Displacement
Abstract
Of the various conservative treatment modalities available for temporomandibular disorders, we believe that therapeutic exercise has a good prognosis, especially for anterior disc displacement without reduction. Since its effectiveness has not been extensively evaluated, we conducted a comparative study to verify the hypothesis that treatment efficacy would not differ for exercise and occlusal splints. Fifty-two individuals with anterior disc displacement without reduction were randomly assigned to a splint or a joint mobilization self-exercise treatment group. Four outcome variables were evaluated: (i) maximum mouth-opening range without and (ii) with pain, (iii) current maximum daily pain intensity, and (iv) limitation of daily functions. All outcome variables significantly improved after 8 weeks of treatment in both groups. In particular, the mouth opening range increased more in the exercise group than in the splint group. This result demonstrates that therapeutic exercise brings earlier recovery of jaw function compared with splints.
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When pooling results from studies with homogeneous interventions and similar outcomes, diagnoses, and available data, pain was significantly reduced in patients receiving MT combined with exercises compared with splint therapy, self-care, or medications.
“When pooling the results from the studies with homogeneous interventions and similar outcomes, diagnoses, and available data, 69,78,87,88,90 we found that pain was significantly reduced in patients receiving MT combined with exercises compared with splint therapy, self-care, or medications.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [88]
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”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [88]
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 (”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [88]
When looking at active mouth opening, MT plus exercises significantly increased active mouth opening compared with splint therapy, self-care, or medications.
“When looking at active mouth opening, 69,87,88,90 we found that MT plus exercises significantly increased active mouth opening compared with splint therapy, self-care, or medications.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [88]
Eight of the trials reported no adverse events with the treatments.
“Eight of the trials 57,65,67,74,75,77,87,88 reported no adverse events with the treatments.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [88]
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Sorted by citations
Armijo-Olivo, S., Pitance, L., Singh, V., Neto, F., Thie, N., & Michelotti, A. (2016) · Physical Therapy · doi:10.2522/ptj.20140548 · Cited by 413 · see citing works
- Authors
- Haketa, T., Kino, K., Sugisaki, M., Takaoka, M., & Ohta, T.
- Affiliations
- Tokyo Medical and Dental University (JP)
- Jikei University School of Medicine (JP)
- Venue
- Journal of Dental Research
- Publisher
- SAGE Publications
- Published
- 2010-08-25
- Volume
- 89
- Issue
- 11
- Pages
- 1259-1263
- ISSN
- 0022-0345 (ISSN-L)
- 1544-0591
- OpenAlex
- W2103142175
- Cited by
- 107
- References
- 0
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 13 · 2023: 6 · 2022: 12 · 2021: 7 · 2020: 10 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 4 · 2015: 7 · 2014: 9 · 2013: 4 · 2012: 7
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Dental Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- International Association for Dental Research
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
- Health Sciences › Health Professions › Emergency Medical Services › Dental Trauma and Treatments
- Keywords
- temporomandibular disorders, anterior disc displacement without reduction, exercise therapy, occlusal splint, joint mobilization, mouth opening range, jaw pain, functional limitations, conservative treatment
- MeSH terms
- Activities of Daily Living, Adult, Anti-Inflammatory Agents, Non-Steroidal, Joint Dislocations, Facial Pain, Female, Follow-Up Studies, Humans, Male, Mastication, Muscle Contraction, Pain Measurement, Phenylacetates, Sleep, Speech, Temporomandibular Joint Disorders, Time Factors, Toothbrushing, Yawning, Range of Motion, Articular, Orthodontic Appliance Design, Treatment Outcome, Occlusal Splints, Temporomandibular Joint Disc, Recovery of Function, Muscle Stretching Exercises
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