A clinical study of nonsurgical treatment for closed lock of the temporomandibular joint

Abstract

We studied the efficacy of nonsurgical treatment in 206 patients (37 males and 169 females) with closed lock of the TMJ, who visited our clinic in 1994. All of the patients were diagnosed with the chart for primary diagnosis and treated with L type chart treatment. Nonsurgical treatment with L type chart was performed by mandibular manipulation technique, oral medication of anti-inflammatory drug, pivot splint therapy and manipulation assisted by pumping.
The results were as follows;
(1) 48 patients were unlocked by mandibular manipulation technique, 14 by medication, 12 by pivot splint therapy and 13 by pumping manipulation. Comparing the successfully unlocked group and the failure group, the locking duration and sound duration were significantly short, and the maximal mouth opening at the initial visit was small in the former group. On the other hand, the degree of pain at the initial visit, was significantly bigger in the unlocked group than in the failure group.
(2) Thirty (18.7%) patients who had closed lock suffered from relapse.
(3) Forty seven (74.6%) patients who had closed lock within 2 weeks were unlocked, however 17 (16.8%) patients who had closed lock more than 1 month were unlocked.
(4) One hundred sixty-three (79.1%) patients who received nonsurgical treatment improved in spite of discrepositioning. Locking duration in the effective group with nonsurgical treatment was significantly smaller than in the ineffective group.