TY - JOUR
T1 - Modified condylotomy versus conventional conservative treatment in painful reciprocal clicking
T2 - a preliminary prospective study in eight patients
AU - Bakke, Merete
AU - Eriksson, Lars
AU - Thorsen, Niels Max
AU - Sewerin, Ib
AU - Petersson, Arne
AU - Wagner, Aase
N1 - Keywords: Adolescent; Adult; Arthralgia; Auscultation; Dislocations; Facial Pain; Female; Humans; Male; Mandibular Condyle; Muscle Stretching Exercises; Occlusal Splints; Oral Surgical Procedures; Pain Measurement; Pilot Projects; Prospective Studies; Sound; Temporomandibular Joint Disorders; Young Adult
PY - 2008
Y1 - 2008
N2 - Modified condylotomy may be relevant in severe painful reciprocal clicking of the temporomandibular joint (TMJ) where conservative treatment is insufficient. The effect of the modified condylotomy was analyzed and compared with conventional nonsurgical treatment in a randomized pilot study of eight patients, 19-44 years of age, with severe painful reciprocal clicking. Before and after treatment, assessments were performed by subjective reports, clinical recordings, and blinded evaluations of radiography and magnetic resonance imaging (MRI). Based on the clinical evaluations before treatment, all conditions were disc displacements with reduction and arthralgia (Research diagnostic criteria for temporomandibular disorders), but based on MRI, one patient had disc displacement without reduction and another had normal disc position. The treatment effect was significantly better and the disorders were significantly more reduced with condylotomy than with conventional nonsurgical treatment (P < 0.05, Mann-Whitney U test). In the surgical group, the clicking and locking had disappeared, the pain during function was significantly reduced (P < 0.05, Friedman ANOVA), and in two patients the disc position was normalized. The clicking still persisted in the nonsurgical patients and the disc position was unchanged. Our conclusion is that modified condylotomy is a promising option to reduce symptoms and signs in severe painful reciprocal clicking.
AB - Modified condylotomy may be relevant in severe painful reciprocal clicking of the temporomandibular joint (TMJ) where conservative treatment is insufficient. The effect of the modified condylotomy was analyzed and compared with conventional nonsurgical treatment in a randomized pilot study of eight patients, 19-44 years of age, with severe painful reciprocal clicking. Before and after treatment, assessments were performed by subjective reports, clinical recordings, and blinded evaluations of radiography and magnetic resonance imaging (MRI). Based on the clinical evaluations before treatment, all conditions were disc displacements with reduction and arthralgia (Research diagnostic criteria for temporomandibular disorders), but based on MRI, one patient had disc displacement without reduction and another had normal disc position. The treatment effect was significantly better and the disorders were significantly more reduced with condylotomy than with conventional nonsurgical treatment (P < 0.05, Mann-Whitney U test). In the surgical group, the clicking and locking had disappeared, the pain during function was significantly reduced (P < 0.05, Friedman ANOVA), and in two patients the disc position was normalized. The clicking still persisted in the nonsurgical patients and the disc position was unchanged. Our conclusion is that modified condylotomy is a promising option to reduce symptoms and signs in severe painful reciprocal clicking.
U2 - 10.1007/s00784-008-0204-x
DO - 10.1007/s00784-008-0204-x
M3 - Journal article
C2 - 18548293
SN - 1432-6981
VL - 12
SP - 353
EP - 359
JO - Clinical Oral Investigations
JF - Clinical Oral Investigations
IS - 4
ER -