title: [Mandibular manipulation technique followed by exercise therapy and occlusal splint for treatment of acute anterior TMJ disk displacement without reduction].
abstract: OBJECTIVE
  This study aimed to evaluate the short-term efficiency of mandibular manipulation technique combined with exercise therapy and splint treatment of acute anterior TMJ disc displacement without reduction (ADDW), and TMJ disc-condyle relationship by magnetic resonance imaging (MRI).
  
  
  METHODS
  Forty-four patients (37 females, 7 males) were diagnosed as acute ADDW and confirmed by MRI. All patients underwent mandibular manipulation, combined with exercise therapy, including jaw movement exercise, stabilization exercise, disc reposition exercise, and splint treatment. Anterior repositioning splint was wore only at night during sleep, while the mandible was kept in rest position during the day. The treatment was continued for 2 weeks. The baseline and endpoint outcome assessment measures were maximum active mouth opening, visual analogue scale (VAS) score of TMJ pain. Consecutive MRI was performed 1~3 months after treatment. SPSS 17.0 software package was used for statistical analysis.
  
  
  RESULTS
  Two weeks after treatment, the patients' maximum active mouth opening increased from(22.6±6.1) mm to (43.9±3.3) mm, VAS score of pain decreased from 3.6±1.5 to 0.7±0.25. After treatment of 4.6±4.7 weeks on average, 20 patients (46%) displayed normal dis-condyle relationship, 16 patients(36%) had displacement with reduction, and 8 patients（18%) had displacement without reduction on MRI.
  
  
  CONCLUSIONS
  Mandibular manipulation technique combined with exercise therapy and splint treatment seems to be useful in the treatment of anterior TMJ disc displacement with reduction, which can help to maintain the complete anatomic disc-condyle relationship.
authors.affiliation: Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China E-mail: jiangxinkylie@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Jiang
authors.forename: Shuai
authors.initials: S
authors.lastname: Fan
authors.forename: Bin
authors.initials: B
authors.lastname: Cai
authors.forename: Zhong-Yi
authors.initials: ZY
authors.lastname: Fang
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Xu
authors.forename: Li-Kun
authors.initials: LK
authors.lastname: Liu
mesh_terms: D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D004204:Joint Dislocations; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible; D017090:Occlusal Splints; D010146:Pain; D013165:Splints; D019224:Temporomandibular Joint Disc; D013705:Temporomandibular Joint Disorders / Q000601:surgery / Q000628:therapy*