1989 Volume 38 Issue 1 Pages 283-291
The efficacy of conservative treatment for TMJ arthrosis with closed lock was evaluated clinically. Twenty patients (mean age: 42.8 years, range: 13 to 76 years) were treated mainly by mandibular manipulation, manipulation after pumping of the superior articular cavity, or a disc recapturing splint to unlock the jaw.
The results were summarized below.
1. The jaw was successfully unlocked in ten patients (50.0%), nine of them under age 40.The treatment was unsuccessful in releasing the closed lock in patients aged over 40 except one, possibly because of advanced degenerative bony change of the mandibular head in most patients.
2. Although an improvement of clinical symptoms was obtained, crepitation in the affected TMJ and additional degenerative bony change were observed in six and four patients, respectively, in whom the jaw remained unlocked.
3. After treatment, complete or almost complete disappearance of symptoms were noted in nine and four patients, respectively.
Partial relief of symptoms was attained in eight patients, but remained unchanged in one patient.
The results were dependent on success or failure in unlocking the jaw.
In conclusion, conservative approach was found to be relatively effective as an initial treatment for closed lock patients, but other conservative approaches or surgical procedures should be attempted in the treatment of patients over age 40 with radiographic evidence of degenerative bony change of the mandibular head.
