Self-reported remission, difficulty, and satisfaction with nonsurgical therapy used to treat anterior disc displacement without reduction

Objective The purpose of this study was to identify the appropriate treatment element for initial anterior disc displacement without reduction subjects. Study design Sixty-nine consecutive patients with temporomandibular joint disc displacement without reduction confirmed on magnetic resonance images were randomly divided into 3 experimental treatment groups. The treatment of group 1 consisted of short-term nonsteroidal anti-inflammatory drugs and self-care instructions (palliative care group); group 2, nonsteroidal anti-inflammatory drugs, self-care instructions, and occlusal appliance and mobilization therapy (physical medicine group); and group 3, no treatment (control group). Outcomes were assessed by means of a 5-item questionnaire that evaluated (1) symptom improvement, (2) difficulty of treatment, and (3) satisfaction with treatment during the 8-week observation period. Results Improvement scores in the palliative care group were significantly better than those in the physical medicine group or the no-treatment group. Satisfaction scores showed no significant difference among the 3 groups. Difficulty from treatment for the physical medicine group was significantly greater than that for other 2 groups. Conclusion These data suggest that palliative care would be more appropriate as the initial therapy to treat painful anterior disc displacement without reduction.