Clinical effect of mandibular manipulation combined with comprehensive physical therapy for treatment of acute anterior disc displacement without reduction

doi:10.19438/j.cjoms.2018.06.007

Abstract

Abstract: PURPOSE: To evaluate the clinical effect of mandibular manipulation combined with comprehensive physical therapy for treatment of acute anterior disc displacement without reduction of temporomandibular joint(TMJ). METHODS: Forty patients (36 females, 4 males) of acute TMJ disc displacement without reduction with limited opening from Jan. 2017 to Dec. 2017 in the Department of Rehabilitation Medicine, Shanghai Ninth People'S Hospital, Shanghai Jiao Tong University School of Medicine, were included in the study. All patients received education, electrotherapy (ultra-short wave diathermy, ultrasound and laser), mandibular manipulation followed by anterior repositioning splint and exercise therapy (disc reposition exercise stabilization exercise and cervical posture exercise). The treatment was continued for 2 weeks, 5 times a week. The baseline and endpoint outcome assessment measures were active maximum mouth opening(MMO), visual analogue scale(VAS) score and mandibular function impairment questionnaire(MFIQ). Consecutive MRI were performed after treatment. SPSS 22.0 software package was used for statistical analysis. RESULTS: After 2 weeks of treatment, MMO increased from (24.5±6.4) mm to (40.1±4.4) mm (P<0.05), VAS at rest dropped from 0(0,0) to 0(0,0)( P>0.05),VAS with opening dropped from 2(0,3) to 0(0,0) (P<0.05), VAS with chewing dropped from 1(0,3) to 0(0,0) (P<0.05) and MFIQ dropped from(25.0±6.5) to (12.3±6.4) (P<0.05). (3.6±3.1) weeks after treatment, 23 patients (57%) were normal, 9 patients (23% ) displayed displacement with reduction and 8 patients(20%) had displacement without reduction. CONCLUSIONS: Mandibular manipulation combined with comprehensive physical therapy can immediately increase mouth opening, relieve pain, improve mandibular function and maintain disc-condyle relationship after successful reposition in the treatment of acute anterior disc displacement without reduction .

Key words: Temporomandibular disorders, Acute anterior disc displacement without reduction, Comprehensive physical therapy, Mandibular manipulation

CLC Number:

R782.6

FANG Zhong-yi, LIU Li-kun, CAI Bin, FAN Shuai, JIANG Xin. Clinical effect of mandibular manipulation combined with comprehensive physical therapy for treatment of acute anterior disc displacement without reduction[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(6): 518-522.

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