Treatment Modalities For Temporomandibular Disorders Research Articles

The Effect of Exercise on Range of Movement and Pain After Temporomandibular Joint Arthrocentesis

Arthrocentesis is an effective treatment modality for temporomandibular disorders, especially in patients who have pain and limited mouth opening. Surgeons generally suggest physical exercises after arthrocentesis and arthroscopy procedures; however, there has been no study in the literature evaluating the effects of exercise on clinical outcomes. This study investigated whether physical exercises after arthrocentesis would result in early improvements in clinical symptoms in patients with temporomandibular joint disc displacement without reduction (TMJ DDw/oR). The study group was composed of 27 patients with TMJ DDw/oR. Patients who needed arthrocentesis after failed conservative nonsurgical treatment were enrolled in the study. Group 1 was composed of 14 patients who were not started on a physiotherapy program after the arthrocentesis procedure. Group 2 was composed of 13 patients who were started on a self-administered physiotherapy program immediately after the arthrocentesis procedure. Physiotherapy included a 6-week exercise program. Patients were followed for 3months. Range of maximal mouth opening (MMO) and joint pain as measured by the visual analog scale (VAS) were examined to determine clinical efficacy before and after treatment. In groups 1 and 2, mouth opening increased and pain scores decreased at 1-week and 1- and 3-month follow-ups (P<.05). No relevant relation was found between the 2 groups according to MMO for all time points and VAS scores at 1week. A relevant relation was found between the 2 groups according to VAS scores at 1 and 3months. Physical exercise after arthrocentesis has no effect on range of mouth opening but does decrease pain.

Diagnosis and Treatment Modalities for Temporomandibular Disorders (Part II)

ABSTRACT Once proper patient evaluation techniques have been implemented and a working differential diagnosis has been created, the clinician can start treatment planning for the temporomandibular disorder (TMD) patient. This is not an easy task, primarily due to the wide array of treatment options currently available. In the second and final part of this article, focus will be placed on various treatment modalities for temporomandibular disorders.

Diagnosis and Treatment Modalities for Temporomandibular Disorders (Part I): History, Classification, Anatomy and Patient Evaluation

ABSTRACT Temporomandibular disorder (TMD) is not just one disorder, but a group of conditions, often painful, that affect the temporomandibular joint, and the muscles that control chewing. Many psychological and physical factors cause myofascial pain, internal derangement of the joint, degenerative joint diseases which ultimately leads to temporomandibular disorder. Scientists are exploring how behavioral, psychological and physical factors may combine to cause temporomandibular disorders and researchers are working to clarify temporomandibular disorders symptoms, with the goal of developing easier and better methods of diagnosis and improved treatment. In part 1 of this 2-part series on temporomandibular disorders, emphasis will be placed on the history and classification of temporomandibular disorders, structure and function of the temporomandibular joint (TMJ), and patient evaluation techniques.

Treatment of patients with temporomandibular disorders – a retrospective treatment comparison

PURPOSE: Effectiveness of splint therapy or exercise therapy has been discussed controversially in literature. This retrospective study was intended to compare effectiveness of splint therapy or exercise therapy alone or with a combination of both methods. MATERIAL OR PATIENTS AND METHODS: The study evaluated 97 patients from the Clinic of Temporomandibular Dysfunction. Pain sensation, muscle pain on palpation, mouth opening and a subjective anamnestic index were assessed before and after therapy and compared. 29 patients received exercise therapy alone (group ET), 37 patients splint therapy alone (group S), and 31 patients a combination with splint therapy plus exercise therapy (group ET + S). RESULTS: Post-therapeutic or post-treatment results showed significant reduction of pain (p < 0.001) and muscle pain on palpation (p < 0.001) in patients of all groups with no significant differences between the individual groups. Mouth opening improved significantly in patients of groups ET and ET + S, but not in those in group S, who had already shown normal mouth opening in the baseline assessment. Subjective patient assessments of the individual items showed a significant improvement in all groups (p < 0.001). CONCLUSION: All treatment modalities for temporomandibular disorders evaluated in this study were shown to be effective with no statistically significant differences seen between the individual groups. However, it must be considered that the baseline findings for the patients in the group with combination therapy were inferior.

An evidence-based assessment of occlusal adjustment as a treatment for temporomandibular disorders

Statement of problem. Occlusal adjustment therapy has been advocated as a treatment modality for temporomandibular disorders. In contrast to this position, a panel at the 1996 National Institute of Health technology assessment conference on TMD indicated that no clinical trials demonstrate that occlusal adjustment is superior to noninvasive therapies. Purpose. This article summarizes the published experimental studies on occlusal adjustments and temporomandibular disorders. Material and methods. Eleven research experiments involving 413 subjects with either bruxism (n = 59), temporomandibular disorders (n = 219), headaches and temporomandibular disorders (n = 91), or chronic cervical pain (n = 40) were selected for critical review from the English dental literature. Results. Three experiments evaluated the relationship between occlusal adjustment and bruxism. Six experiments evaluated occlusal adjustment therapy as a treatment for patients with primary temporomandibular disorders. One experiment looked at occlusal adjustment effect on headache/temporomandibular disorder symptoms; another looked at its effect on chronic neck pain. Most of these experiments used a mock adjustment or a comparison treatment as the control condition in adults who had an existing nonacute general temporomandibular disorder. Overall, the data from these experiments did not demonstrate elevated therapeutic efficacy for occlusal adjustment over the control or the contrasting therapy. Conclusion. The experimental evidence reviewed was neither convincing nor powerful enough to support the performance of occlusal therapy as a general method for treating a nonacute temporomandibular disorder, bruxism, or headache. (J Prosthet Dent 2001;86:57-66.)

Temporomandibular disorders. Part 3. Surgical treatment

Surgery of the temporomandibular joint has a small but nonetheless important role in the overall management of temporomandibular disorders. Appropriate case selection is the mandatory requirement for successful surgical intervention in order to achieve the desired outcome of treatment, such as relief of symptoms and improved function. In this, the third article in the series, a general overview of the current surgical treatment modalities for temporomandibular disorders will be presented.

Temporomandibular disorders. 2. Non‐surgical treatment

There are many treatment modalities for temporomandibular disorders (TMD), most of which are effective in controlling symptoms, at least in the short term. The non-surgical treatment of temporomandibular disorders continues to be the most effective way of managing over 80 per cent of patients who present with symptoms of temporomandibular pain and dysfunction. In this, the second article in the series, a general overview of the current non-surgical treatment strategies for TMD will be presented.