Long-term outcomes of nonsurgical treatment in nonreducing anteriorly displaced disk of the temporomandibular joint.
OBJECTIVE
The aim of this study was to evaluate long-term outcomes of nonsurgical treatment in patients with persistent anterior disk displacement without reduction of the temporomandibular joint.


METHODS
Thirty-five patients were treated with occlusal splints, and 12 patients underwent additional occlusal treatments after splint treatment. These patients were evaluated clinically and radiographically. At least 2 years after the treatment, the 34 patients' symptoms were assessed with the use of a questionnaire.


RESULTS
The mean maximal interincisal distance (MID) was 27.6 mm before treatment and 44.4 mm at the end of treatment (p < 0.001). Before the treatment, all 35 patients had complained of pain, and mild pain persisted in 9 patients at the end of treatment. Flattening of the condylar head and of the articular eminence increased in prevalence from 12.1% and 9.1%, respectively, before treatment to 54.5% and 51.5%, respectively, at the time of follow-up observation. At the time of the survey, the mean self-reported MID was 46.8 mm (p < 0.01).


CONCLUSIONS
After the nonsurgical treatment, the clinical signs and symptoms improved significantly, although the prevalence of osteoarthrotic findings increased.
Kai
S
S
First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
Kai
H
H
Tabata
O
O
Shiratsuchi
Y
Y
Ohishi
M
M
D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005157:Facial Pain / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008137:Longitudinal Studies; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use; D019558:Occlusal Adjustment; D017090:Occlusal Splints; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology; D015995:Prevalence; D011859:Radiography; D016059:Range of Motion, Articular; D011795:Surveys and Questionnaires; D013701:Temporal Bone / Q000000981:diagnostic imaging; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009465:Neuromuscular Agents