H Minakuchi1, T Kuboki, K Maekawa, Y Matsuka, H Yatani. 1. Department of Oral and Maxillofacial Rehabilitation, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan.
Abstract
OBJECTIVE: The purpose of this study was to identify the appropriate treatment element for initial anterior disc displacement without reduction subjects. STUDY DESIGN:Sixty-nine consecutive patients with temporomandibular joint disc displacement without reduction confirmed on magnetic resonance images were randomly divided into 3 experimental treatment groups. The treatment of group 1 consisted of short-term nonsteroidal anti-inflammatory drugs and self-care instructions (palliative care group); group 2, nonsteroidal anti-inflammatory drugs, self-care instructions, and occlusal appliance and mobilization therapy (physical medicine group); and group 3, no treatment (control group). Outcomes were assessed by means of a 5-item questionnaire that evaluated (1) symptom improvement, (2) difficulty of treatment, and (3) satisfaction with treatment during the 8-week observation period. RESULTS:Improvement scores in the palliative care group were significantly better than those in the physical medicine group or the no-treatment group. Satisfaction scores showed no significant difference among the 3 groups. Difficulty from treatment for the physical medicine group was significantly greater than that for other 2 groups. CONCLUSION: These data suggest that palliative care would be more appropriate as the initial therapy to treat painful anterior disc displacement without reduction.
RCT Entities:
OBJECTIVE: The purpose of this study was to identify the appropriate treatment element for initial anterior disc displacement without reduction subjects. STUDY DESIGN: Sixty-nine consecutive patients with temporomandibular joint disc displacement without reduction confirmed on magnetic resonance images were randomly divided into 3 experimental treatment groups. The treatment of group 1 consisted of short-term nonsteroidal anti-inflammatory drugs and self-care instructions (palliative care group); group 2, nonsteroidal anti-inflammatory drugs, self-care instructions, and occlusal appliance and mobilization therapy (physical medicine group); and group 3, no treatment (control group). Outcomes were assessed by means of a 5-item questionnaire that evaluated (1) symptom improvement, (2) difficulty of treatment, and (3) satisfaction with treatment during the 8-week observation period. RESULTS: Improvement scores in the palliative care group were significantly better than those in the physical medicine group or the no-treatment group. Satisfaction scores showed no significant difference among the 3 groups. Difficulty from treatment for the physical medicine group was significantly greater than that for other 2 groups. CONCLUSION: These data suggest that palliative care would be more appropriate as the initial therapy to treat painful anterior disc displacement without reduction.