2021 Volume 33 Issue 2 Pages 45-50
TMDs are dysfunctions of locomotor organs such as TMJ and muscles used for mastication, and exercise therapy is reported to be useful for functional recovery. However, the technique and method of teaching exercise therapy according to the pathological condition of TMDs have not been clarified, and so it is necessary to increase the number of cases and evaluate each pathological condition in detail in order to establish the technique and teaching method. We report two cases: the first patient visited the hospital with the chief complaint of being unable to close her mouth at meal times, had left-sided temporomandibular disc derangement without reduction, and was unable to open her mouth wide at meal times. The second patient was diagnosed with left- and right-sided temporomandibular disc derangement with reduction, and exhibited mouth closure and opening during an opening/closing movement test. In both cases, we confirmed the position where the open state was impaired by reproducing the impaired state and instructed the patients to perform joint range of motion training as an exercise therapy aimed at increasing the range of motion from that state. Furthermore, when the TMJ was manually mobilized as an exercise therapy aimed at expanding its cavity and range of motion, the closure disorder and trismus disappeared in both cases. Based on these facts, in cases of temporomandibular joint disc derangement, it may be important to evaluate the amount of opening movement and the quality of opening and closing movements, and to clarify the problem and reflect it in exercise therapy instead of uniform exercise therapy.