復位を伴わない関節円板前方転位に対する治療法の検討

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This study was undertaken in order to evaluate the effectiveness of treatment for anterior disk displacement without reduction (closed-lock). Of 61 patients who had been clinically diagnosed as having closed-lock of the TMJ, 28 were treated with splint alone, 14 with mandibular manipulation followed by splint and 19 with manipulation assisted by pumping. In addition, 8 patients in whom non-surgical treatments had failed to be beneficial were treated by surgery. The conclusions are summarized as follows: 1. In 41 of 61 patients, signs and symptoms of closed-lock disappeared after the initial treatment. Although 13 patients suffered a relapse of closed-lock, 7 were improved again by splint therapy and 37 (57%) were finally improved from closed-lock by non-surgical treatment .2. The results of each non-surgical treatment were almost equal. However, the patients who were treated by manipulation assisted by pumping had a tendency to improve faster from closed-lock but easily suffered relapse. On the other hand, the splint treated patients had a tendency to resist the treatment but did not suffer a relapse. 3. The results of non-surgical treatment were closely related to the duration of closed-lock. 65% of the patients who had been suffering closed lock for less than 6 months were improved, but only 25% of the patients suffering for more than 6 months were improved. In the patients who had recovered from closed-lock by mandibular manipulation or manipulation assisted by pumping, 60% of the patients who had closed-lock within one month were improved finally, and all patients who had closed-lock over one month suffered a relapse. 4. Seven out of 8patients who had undergone TMJ surgery recovered from limited mouth opening and pain of the TMJ, but 3 patients had a deflection of the mandible on maximal opening.
社団法人日本口腔外科学会の論文

復位を伴わない関節円板前方転位に対する治療法の検討

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