Abstract
Question: Is minimal treatment effective in people who have anterior disk displacement?
Objective To evaluate non-surgical treatments of anterior disk displacement without reduction (ADDwor).
Design Randomised controlled trial (RCT) in a hospital setting.
Intervention A total of 69 Magnetic Resonance Imaging (MRI) – confirmed ADDwor subjects were randomly assigned to either a control group (C) that received explanation and advice, a self-care group (SC) who received a nonsteroidal anti-inflammatory drug (25 mg diclofencac tds) and self-care protocol, or a third group (PM) that received in addition the fitting of an occlusal appliance and intermittent manual jaw mobilisation therapy. Calibrated examiners collected data at the initial interview and at 0, 2, 4 and 8 weeks.
Outcome measures Maximum mouth opening, visual analogue scale of pain (VAS-pain), and daily activity limitation (DAL).
Results At the 8-week point, within-group improvements were present for all variables for all groups. Between-group differences were not highly evident (see Table 1)
Conclusion The results suggest that ADDwor subjects will normally improve with only minimal treatment intervention. No significant differences were evident for the treatments tested against the control. The gradual reduction of signs and symptoms in ADDwor in treatment and control groups seems to be more related to the passage of time rather than the type of treatment.
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Minakuchi H, Kuboki T, Malsuka Y, Maekawa K, Yatani H, Yamashita A. A randomized controlled evaluation of non-surgical treatments for temporomandibular joint anterior disk displacement without reduction. J Dent Res 2001; 80:924–928
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Juniper, R. Patients with anterior disk displacement improve with minimal treatment. Evid Based Dent 3, 69 (2002). https://doi.org/10.1038/sj.ebd.6400113
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DOI: https://doi.org/10.1038/sj.ebd.6400113