A randomized controlled trial of therapeutic exercise for clicking due to disk anterior displacement with reduction in the temporomandibular joint.
Therapeutic exercise is a new concept of treatment for patients with clicking due to anterior disk displacement with reduction (ADDWR). In order to investigate the efficacy of the exercise, we designed a randomized controlled clinical trial to compare with no-treatment controls. The subjects were patients who complained of painless unilateral reciprocal clicking and were diagnosed as having ADDWR by Magnetic Resonance Imaging (MRI). Forty-two patients were randomly assigned. Three months after the randomization, the success rate was 61.9% (13/21 joints) in the exercise group and 0% (0/21 joints) in the control group, with a significant difference between the two groups (p=0.0001). However, captured disks in the successful cases were seen in only 23.1% on MRI examination. In conclusion, the therapeutic exercise for clicking due to ADDWR is significantly effective in reducing the clicking, and thought to be much more conservative and cost-effective than splint therapy or surgery.
Yoda
Tetsuya
T
Department of Oral-maxillofacial Surgery, Dentistry and Orthodontics, Graduate School of Medicine, University of Tokyo, Japan. yodat-ora@h.u-tokyo.ac.jp
Sakamoto
Ichiro
I
Imai
Hideki
H
Honma
Yoshinobu
Y
Shinjo
Yu
Y
Takano
Atsushi
A
Tsukahara
Hiroyasu
H
Morita
Shin
S
Miyamura
Juichi
J
Yoda
Yasushi
Y
Sasaki
Yoshiyuki
Y
Tomizuka
Ken
K
Takato
Tsuyoshi
T
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008875:Middle Aged; D009068:Movement; D016059:Range of Motion, Articular / Q000502:physiology; D013016:Sound; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D019224:Temporomandibular Joint Disc / Q000473:pathology / Q000503:physiopathology*; D016896:Treatment Outcome