This Article Full Text Full Text (PDF) Data Supplement Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schiffman, E.L. Articles by Fricton, J.R. Search for Related Content PubMed PubMed Citation Articles by Schiffman, E.L. Articles by Fricton, J.R. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Dislocations Joint Disorders Temporomandibular Joint Dysfunction Hazardous Substances DB METHYLPREDNISOLONE Social Bookmarking                         What's this?

Randomized Effectiveness Study of Four Therapeutic Strategies for TMJ Closed Lock

¹ University of Minnesota School of Dentistry, Department of Diagnostic and Biological Sciences,
³ Department of Developmental and Surgical Sciences, 6-320 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455, USA;
² University of Minnesota School of Public Health, Division of Biostatistics, Minneapolis, MN, USA; and
⁴ Veterans Administration Hospital Dental Clinic, Minneapolis, MN, USA

Correspondence: ^* corresponding author, schif001{at}umn.edu

For individuals with temporomandibular joint (TMJ) disc displacement without reduction with limited mouth opening (closed lock), interventions vary from minimal treatment to surgery. In a single-blind trial, 106 individuals with TMJ closed lock were randomized among medical management, rehabilitation, arthroscopic surgery with post-operative rehabilitation, or arthroplasty with post-operative rehabilitation. Evaluations at baseline, 3, 6, 12, 18, 24, and 60 months used the Craniomandibular Index (CMI) and Symptom Severity Index (SSI) for jaw function and TMJ pain respectively. Using an intention-to-treat analysis, we observed no between-group difference at any follow-up for CMI (p 0.33) or SSI (p 0.08). Both outcomes showed within-group improvement (p < 0.0001) for all groups. The findings of this study suggest that primary treatment for individuals with TMJ closed lock should consist of medical management or rehabilitation. The use of this approach will avoid unnecessary surgical procedures.

Key Words: temporomandibular joint • closed lock • randomized clinical trial • effectiveness study

Journal of Dental Research, Vol. 86, No. 1, 58-63 (2007)
DOI: 10.1177/154405910708600109


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?