Exercise therapy maintains the disc-condyle relationship after mandibular manipulation to correct anterior temporomandibular joint displacement

Abstract

Abstract: PURPOSE: To evaluate the clinical possibility and results of maintaining disc-condyle relationship by exercise therapy after successful manual reposition of temporomandibular joint (TMJ) disc. METHODS: Nineteen patients of acute TMJ disc displacement without reduction with limited opening underwent successful manual reposition of TMJ disc from Oct. 2013 to Jan. 2016 in the Department of Rehabilitation Medicine, Shanghai Ninth People'S Hospital, Shanghai Jiao Tong University School of Medicine, were included in the study. The patients were treated by mandibular manipulation aided by occlusal splint technique and exercises, including disc reposition exercise,jaw movement exercise, stabilization exercise and cervical posture exercise. The treatment was continued for 2 weeks, 5 times a week. Before and after treatment, and at 1, 6, 12-month of follow-up, maximum active mouth opening (mm) and visual analogue scale (VAS) of pain were evaluated. MRI was performed 1,6 and 12 months after treatment. The data were compared between pre- and post-therapy with paired t test and χ² test using SPSS 19.0 software package. RESULTS: Two weeks after treatment, the maximum active mouth opening was increased from (21.5±5.9)mm to (40.2±1.8)mm(P<0.05), VAS score dropped from 0.9±1.6 to 0(P<0.05). One, 6 and 12 months after treatment, the maximum active mouth opening was≥40 mm, and VAS score was 0. Six months after treatment, 18 patients (95%) were normal, 1 patients (5%) displayed displacement with reduction on MRI. Twelve months after treatment, 15 patients (79%) were normal, 3 patients（16%） displayed displacement with reduction, 1 patients (5%) had displacement without reduction on MRI. No significant relationship was found on MRI after treatment (P>0.05). CONCLUSIONS: The results indicate that exercise therapy can help to maintain disc-condyle relationship after successful reposition of acute TMJ anterior disc displacement without reduction via mandibular manipulation aided by occlusal splint.

Key words: Temporomandibular disorders, Disc displacement without reduction, Exercise therapy, Mandibular manipulation, Disc-condyle relationship

CLC Number:

R782.6

JIANG Xin, LIU Li-kun, CAI Bin, FANG Zhong-yi, XU Li-li, FAN Shuai. Exercise therapy maintains the disc-condyle relationship after mandibular manipulation to correct anterior temporomandibular joint displacement[J]. China Journal of Oral and Maxillofacial Surgery, 2016, 14(5): 435-439.

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