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 Management of Masticatory
Muscle and/or Temporomandibular Joint Disorders: Comparison
of three treatments
Akiko Ohtsuka, Hiroshi Kurita , Kenji Kurashina
Objectives: The purpose of this study is to
evaluate the response of the patients with masticatory
muscle and/or temporomandibular joint (TMJ) disorders to
natural course, anti-inflammatory medication, or occlusal
splint therapy.
Methods: Forty-three patients were eligible and were
randomly assigned to three groups: 16 patients were informed
and observed without any treatments (natural course); 15
patients were treated with a regular use of non-steroidal
anti-inflammatory drug (loxoprofen sodium) (medication
group); and 12 patients were treated with maxillary full
coverage type of occlusal splint (splint group). Clinical
symptoms and signs (pain score, mouth opening capacity, and
chewing ability) were evaluated before and after the initial
of treatments at weekly schedule for four weeks. Total
remission rate and change of the sings and symptoms were
compared among the groups.
Results: Total remission was obtained in 73% of the
splint group, 46% in the medication group, and 44% in
natural course. The differences were not statistically
significant (Mann-Whitneyﾕs U test, P>0.05). The pain
sore of the splint group went down more quickly than those
of natural course (repeated measure ANOVA, P<0.05)., and
there was a significant difference as to the change of mouth
opening capacity between the medication and the splint group
(repeated measure ANOVA, P<0.05).
Conclusion: The results of this study showed that
there was no significant difference as to the remission rate
among three treatments in the short-term interval. However,
it was suggested that there might be a significant benefit
of splint therapy over natural course or medication.
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 A Study on the Relationship between the TMJ
Condyle Position and Internal Derangement
Hiroshi Kurita, Akiko Ohtsuka, Kenji Kurashina
Objectives: The purpose of this study is to
evaluate the difference in temporomandibular joint (TMJ)
condyle position among the joints with no disk displacement
(NDD), the joint with reducible disk displacement (RDD), and
the joints with permanently displaced disks (PDD). The
relationship between condyle position and internal
derangement was discussed.
Methods: Forty-eight joints with NDD, 84 joints with
RDD, and 99 joints with PDD were available for the study.
The condyle as well as TMJ disk position was calculated
using a magnetic resonance imaging. Studentﾕs or Welchﾕs
t-test was used to test for differences. P value of less
than 0.05 was considered to indicate statistical
significance.
Results: There were statistically significant
differences as to the condyle position between the joints
with NDD and those with RDD, with the condyle in the joints
with RDD being located more posteriorly (Studentﾕs t-test,
p<0.05). On the other hand, there was no significant
difference between the joint with NDD and those with PDD. In
the measurement of the disk position, the permanently
displaced disks were located more anteriorly than the
reducibly displaced disks (Studentﾕs t-test, p<0.01).
Conclusions: From the results of this study it was
suggested that the condyles shifted backward in the joints
where the disk were displaced anteriorly and were reducible.
In the joint with disk displacement without reduction, the
displaced disks were located more anteriorly and the
condyles were located in the almost similar position as in
the joints with no disk displacement.
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