Abstract
The purpose of this study was to compare two physiotherapy programmes for rehabilitation
after temporomandibular joint (TMJ) arthroscopy. The medical files of 137 consecutive
patients diagnosed with closed lock and treated by arthroscopic lysis and lavage were
analyzed retrospectively. Sixty-eight patients were rehabilitated with gradually increasing
range of motion self-exercises (gradual programme) and 69 patients were rehabilitated
with immediate full range of motion self-exercises (immediate programme). The outcome
variables were maximum mouth opening (MMO) and pain (on a visual analogue scale).
The postoperative measurements taken at 1 month, 6 months, and last follow-up examination
available (mean of 10 months postoperative) were analyzed and compared between the
two groups. The results showed significantly better MMO and pain outcomes for the
immediate group than for the gradual group at the 1-month and 6-month postoperative
evaluations. The results of the two groups were comparable at the last follow-up examination
available. It is concluded that after arthroscopic treatment of closed lock of the
TMJ, a physiotherapy programme consisting of immediate postoperative full range of
motion mobilizations achieves better results (in terms of pain and mouth opening)
than a physiotherapy programme consisting of gradual and controlled increases in range
of motion.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Post-operative physical therapy of the temporomandibular joint.in: Stegenga B. de Bont L. Management of temporomandibular joint degenerative diseases. Birkhauser, Basel, Switzerland1996: 177-189
- Postarthroscopy physical therapy management of a patient with temporomandibular joint dysfunction.J Orthop Sport Phys Ther. 1993; 18: 473-478
- Clinical management of a patient following temporomandibular joint arthroscopy.Phys Ther. 1992; 72: 355-364
- Outcomes of temporomandibular joint arthroscopy in patients with painful but otherwise normal joints.J Craniomaxillofac Surg. 2015; 43: 940-943https://doi.org/10.1016/j.jcms.2015.03.035
- A review of 56 cases of chronic closed lock treated with temporomandibular joint arthroscopy.J Oral Maxillofac Surg. 2002; 60: 519-524https://doi.org/10.1053/joms.2002.31848
- Outcomes of 152 temporomandibular joints following arthroscopic anterolateral capsular release by holmium:YAG laser or electrocautery.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 546-551
- Four-year follow-up study of temporomandibular joint arthroscopic surgery for advanced stage internal derangements.J Oral Maxillofac Surg. 1996; 54 (discussion 291): 285-290
- Arthroscopy of the temporomandibular joint for the treatment of chronic closed lock.Isr Med Assoc J. 2016; 18: 397-400
- Treatment of intermittent locking of the jaw in Wilkes stage II derangement by arthroscopic lysis and lavage.J Oral Maxillofac Surg. 2015; 73: 1466-1472https://doi.org/10.1016/j.joms.2015.02.027
- Temporomandibular joint arthroscopy: a 6-year multicenter retrospective study of 4,831 joints.J Oral Maxillofac Surg. 1992; 50: 926-930
- Arthroscopic surgery of the temporomandibular joint: treatment of internal derangement with persistent closed lock.Oral Surg Oral Med Oral Pathol. 1986; 62: 361-372
- Use of coblation in arthroscopic surgery of the temporomandibular joint.J Oral Maxillofac Surg. 2010; 68: 2085-2091https://doi.org/10.1016/j.joms.2009.04.130
- Long-term evaluation following temporomandibular joint arthroscopy with lysis and lavage.Int J Oral Maxillofac Surg. 2000; 29: 259-263
- The effect of physiotherapy on post-temporomandibular joint surgery patients.J Oral Rehabil. 2002; 29: 441-446https://doi.org/10.1046/j.1365-2842.2002.00850.x
- Effect of an early supervised rehabilitation programme compared with home-based exercise after temporomandibular joint condylar discopexy: a randomized controlled trial.Int J Oral Maxillofac Surg. 2016; 46: 314-321https://doi.org/10.1016/j.ijom.2016.07.010
- Randomized controlled trial on physical therapy for TMJ closed lock.J Dent Res. 2012; 91: 364-369https://doi.org/10.1177/0022034512438275
- Self-reported remission, difficulty, and satisfaction with nonsurgical therapy used to treat anterior disc displacement without reduction.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 435-440https://doi.org/10.1016/j.tripleo.2003.11.013
- The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial.J Am Dent Assoc. 2006; 137: 1099-1107
- The role of physical therapy in recovery after temporomandibular joint surgery.J Oral Maxillofac Surg. 1993; 51: 495-498
- Physical therapy for the postsurgical TMJ patient.J Craniomandib Disord. 1989; 3: 75-82
- A systematic review of the effectiveness of physical therapy interventions for temporomandibular disorders.Phys Ther. 2006; 86: 710-725https://doi.org/10.1007/s00586-010-1518-3
- Manual physical therapy interventions and exercise for patients with temporomandibular disorders.Cranio. 2006; 24: 283-291https://doi.org/10.1179/crn.2006.044
- Effectiveness of manual therapy and home physical therapy in patients with temporomandibular disorders: a randomized controlled trial.J Bodyw Mov Ther. 2013; 17: 302-308https://doi.org/10.1016/j.jbmt.2012.10.006
- Randomized clinical trial of treatment for TMJ disc displacement.J Dent Res. 2010; 89: 1259-1263https://doi.org/10.1177/0022034510378424
- Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: a combination of NSAIDs and mouth-opening exercise versus no treatment.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91: 671-675https://doi.org/10.1067/moe.2001.114005
- A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder.Phys Ther. 2006; 86: 955-973
- Home-exercise regimes for the management of non-specific temporomandibular disorders.J Oral Rehabil. 2005; 32: 779-785
- Rehabilitation of the temporomandibular joint after arthroscopic surgery.Oral Surg Oral Med Oral Pathol. 1992; 73: 531-536
- TMJ arthroscopy—a preoperative and postoperative rehabilitation protocol.J Craniomandib Disord. 1989; 3: 218-226
- Physical therapy post-arthroscopic TMJ management (update).Cranio. 1992; 10: 130-137
- Postoperative physical therapy in temporomandibular joint arthroplasty.Cranio. 1992; 10: 211-220
- Physical therapy in the postoperative management of temporomandibular joint arthroscopic surgery.Cranio. 1989; 7: 27-32
- Internal derangements of the temporomandibular joint. Pathological variations.Arch Otolaryngol Head Neck Surg. 1989; 115: 469-477
- Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group.J Oral Facial Pain Headache. 2014; 28: 6-27https://doi.org/10.11607/jop.1151
- Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint.Ann Maxillofac Surg. 2015; 5: 158-162https://doi.org/10.1053/joms.2001.21002
- Pharmacologic management of temporomandibular disorders.Oral Maxillofac Surg Clin North Am. 2008; 20: 197-210https://doi.org/10.1016/j.coms.2007.12.005
- The natural course of anterior disc displacement without reduction in the temporomandibular joint: follow-up at 6, 12, and 18 months.J Oral Maxillofac Surg. 1997; 55: 234-239https://doi.org/10.1016/S0278-2391(97)90531-0
- Management of nonreducing temporomandibular joint disk displacement: evaluation of three treatments.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 80: 384-388
- Natural course of untreated symptomatic temporomandibular joint disc displacement without reduction.J Dent Res. 1998; 77: 361-365
- Effects of four treatment strategies for temporomandibular joint closed lock.Int J Oral Maxillofac Surg. 2014; 43: 217-226https://doi.org/10.1016/j.ijom.2013.07.744
- Randomized effectiveness study of four therapeutic strategies for TMJ closed lock.J Dent Res. 2007; 86: 58-64
- Article analysis and evaluation: TMJ closed lock symptoms improve, regardless of intervention.J Evid Based Dent Pract. 2008; 8: 19-21https://doi.org/10.1016/j.jebdp.2007.12.005
- Importance of time as a factor in the management of temporomandibular joint closed lock.Int J Oral Maxillofac Surg. 2014; 43: 1302-1303https://doi.org/10.1016/j.ijom.2014.07.003
- No significant differences between conservative interventions and surgical interventions for TMJ disc displacement without reduction.Evid Based Dent. 2014; 15: 90-91
- The role of surgery in the management of disorders of the temporomandibular joint: a critical review of the literature. Part 2.Int J Oral Maxillofac Surg. 2005; 34: 231-237https://doi.org/10.1016/j.ijom.2004.06.006
- Temporomandibular joint surgery: what does it mean to the dental practitioner?.Aust Dent J. 2011; 56: 257-264https://doi.org/10.1111/j.1834-7819.2011.01351.x
- Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction.Int J Oral Maxillofac Surg. 2012; 41: 109-113https://doi.org/10.1016/j.ijom.2011.07.907
- Rationale for early versus late intervention with arthroscopy for treatment of inflammatory/degenerative temporomandibular joint disorders.J Oral Maxillofac Surg. 2010; 68: 2661-2667https://doi.org/10.1016/j.joms.2010.05.051
Article info
Publication history
Published online: November 14, 2017
Accepted:
October 23,
2017
Identification
Copyright
© 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
