[Morphological and positional changes in the disk after nonsurgical therapy. The MRI documentation and clinical correlations].
OBJECTIVE
To evaluate the position and shape of the disc using MNR before and after non-surgical therapy and to correlate MNR findings with other signs and symptoms.


METHODS
MNR imaging of 26 joints belonging to a selected sample of 13 patients (7 F, 6 M, mean age 27 years) with signs and symptoms were compared with MNR performed after a period of non-surgical treatment that included a combination of splint therapy, psychoeducational advice, drugs and physiotherapeutic aids, including manipulation. The criteria for selection were monolateral symptoms and bilateral nature at the initial NMR showing reducible and non-reducible dislocation not associated with degenerative changes and/or effusion. The interval between diagnostic NMR and control imaging was approximately 12 months. The interval between splint application and control NMR was approximately 8 months. NMR included a sagittal study with the mouth open and shut and a coronal study only with the mouth shut using 3 mm-wide cuts. Post-therapy RMN was performed without the splint in position.


RESULTS
The comparison between NMR images showed that 17 of the 26 joints studied had a stationary pathological situation and 9 were in evolution. In spite of these pathological NMR images, the signs and symptoms were found to have regressed or improved.


CONCLUSIONS
These findings can be interpreted in two ways: the disc dislocation and deformation are compatible with the lack of signs and symptoms, or many dislocations should be regarded as an anatomical variation rather than an abnormality.
Desiate
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Istituto di Odontostomatologia e Chirurgia Max-Facciale, Università degli Studi, Bari.
Milano
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D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D026741:Physical Therapy Modalities / Q000379:methods; D011613:Psychotherapy; D012074:Remission Induction; D013165:Splints; D019224:Temporomandibular Joint Disc / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000628:therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal