Abstract:

Objective To explore short term efficacy of the stabilized splint and the combination of manipulative and physical therapies for temporomandibular joint (TMJ) disc displacement without reduction. Methods One hundred and sixty-eight patients with TMJ disc displacement without reduction who visited the Department of Prosthodontics of Shanghai Ninth Peoples Hospital affiliated to Shanghai Jiao Tong University School of Medicine from Feb. 2013 to Mar. 2015 were enrolled and randomly assigned to stabilized splint group (group 1), combination of manipulative and physical therapies group (group 2), stabilized splint and combination of manipulative and physical therapies group (group 3), and control group (group 4). The degree of pain and pain-free maximum active mouth opening among all patients were evaluated before treatment and every three weeks during three months of treatment. Results For VAS values of spontaneous masseter pain, the differences in group 1, group 2, and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05) and the difference in group 4 before treatment and 12 weeks after treatment was statistically significant. For VAS values of palpation pain, the differences in group 2 and group 3 before treatment and 6 weeks after treatment were statistically significant (P<0.05), the difference in group 1 before treatment and 9 weeks after treatment was statistically significant (P<0.05), and the difference in group 4 before treatment and 12 weeks after treatment was statistically significant (P<0.05). For VAS values of chewing pain, the differences in group 1 and group 2 before treatment and 6 weeks after treatment were statistically significant (P<0.05), the difference in group 3 before treatment and 3 weeks after treatment was statistically significant (P<0.05), and the difference in group 4 before and after treatment was not statistically significant (P≥0.05). For pain-free maximum mouth opening, the difference in group 1 before treatment and 9 weeks after treatment was statistically significant (P<0.05), the differences in group 2 and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05), the differences in group 2 and group 3 before treatment and 3 weeks after treatment were statistically significant (P<0.05), and the difference in group 4 before and after treatment was not statistically significant (P≥0.05). Conclusion Both splints and the combination of manipulative and physical therapies can alleviate most muscle and joint pain in short term. Health education may partly alleviate pain. Splints and the combination of manipulative and physical therapies can rapidly improve the mouth opening of patients and satisfy the basic physiological function.

Key words: temporomandibular joint, disc displacement without reduction, splint, physical therapy