Natural course of disc displacement with reduction of the temporomandibular joint: Changes in clinical signs and symptoms

Abstract

Purpose: The goal of this study was to examine the natural course of disc displacement with reduction in the temporomandibular joint (TMJ). Patients and Methods: This retrospective study involved 24 patients who had been diagnosed with disc displacement with reduction of the TMJ, but who had not undergone any treatment. The extent of maximal mouth opening, protrusion, lateral excursions, noise of the TMJ, pain of the TMJ, and tenderness of masticatory muscles were recorded monthly for a mean of 25.8 months. Results: Maximal mouth opening, protrusion, and lateral excursions remained unchanged during follow-up. TMJ pain decreased by 15.7% (P > .05). Clicking decreased by 20.8% (P < .05), and tenderness of masticatory muscles decreased by 33.3% (P < .05). Reciprocal clicking remained unchanged in 19 patients (79.2%) and disappeared in 5 patients (23.8%). Four patients (16.7%) in whom clicking disappeared had a normal mouth opening, but locking developed in 1 patient (4.2%). Conclusions: In patients with disc displacement with reduction who do not undergo treatment, range of movement remains unchanged over time. Tenderness of masticatory muscles tended lessen, but reciprocal clicking and TMJ pain tended to remain. Clicking did not progress to locking in most patients. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:32-34, 2003