Disc displacement without reduction – clinical and instrumental analysis of treatment results
Journal Title: Journal of Stomatology (Czasopismo Stomatologiczne) - Year 2012, Vol 65, Issue 5
Abstract
Introduction. Closed lock is a disease entity that is characterized by a limitation of jaw movement and pain in the temporomandibular region. Aim of the study. To evaluate the results of treatment of patients with disc displacement without reduction by the use of occlusal decompression splint by P. H. Dupas. Material and methods. 8 patients treated for disc displacement without reduction were examined by clinical and instrumental analysis. Clinical examination of range of jaw movements, pain assessment on the VAS scale and condylography by Cadiax Compact 2 (Gamma Dental, Austria, 2010) system were carried out. The patients used lower decompression splint for 3 months. After this period, the patients underwent control examination. Results. At the initial examination, the range of opening movement oscillated from 23 mm to 29 mm. Lateral movements toward the locked side ranged from 10 mm to 12 mm and movements to the opposite side from 5 mm to 7 mm. Pain intensity on the VAS scale ranged from 5 to 9. Condylography confirmed limitation of movement on the side where closed lock was suspected. After 3 months of using the splint with covered molars on the side of the affected joint, the range of jaw movements in opening was from 34 mm to 46 mm. Lateral movements toward the affected side was from 10 mm to 14 mm, on the opposite side from 10 mm to 13 mm. The condylographic images of trajectories of opening and closing jaw movements were extended on the side of the locked joint. In all cases, condylographic tracings indicated irregular characteristics of the movement trajectory of the joint with closed lock. The examined patients reported no pain symptoms. Conclusion. The treatment of patients with diagnosed disc replacement without reduction with the presented method was clinically effective, however, the results of condylography indicate the need for further rehabilitation of masticatory organ in these patients.
Authors and Affiliations
Bartłomiej Loster, Jolanta Loster, Aneta Wieczorek
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