Effects of Different Therapeutic Modalities on the Clicking Sound and Quantitative Assessment of the Vertical and Lateral Mandibular Movements of Patients with Internal Derangements of the Temporomandibular Joint

Purpose: To compare the efficacy of low-dose laser therapy to that of conservative treatment usingtwo different occlusal splints (stabilization and anterior repositioning splints) in patients with internalderangements of the temporomandibular joint (TMJ). Materials and Methods: The study populationconsisted of patients with disc displacement with reduction diagnosed according to the Research DiagnosticCriteria for Temporomandibular Disorders (RDC/TMD) Axis I and Axis II. In addition, disc displacement withreduction was confirmed in all patients using TMJ ultrasonography. These tests were conducted for 6 monthswith an interim control in the third month. The “clicking” sound from the joint on opening and closing themouth and the extent to which the mouth opened vertically and laterally were assessed. In all, 20 patientsreceived low-dose laser therapy, 20 were treated with a stabilization splint, and 20 were treated with ananterior repositioning splint. In addition, 10 untreated patients were included as a patient control group,and a further 10 healthy subjects were included as a healthy control group. Changes in the condition wereassessed based on the results of the RDC/TMD Axis II and with the use of an algometer. Results: Theanterior repositioning splint group showed improvement in the “clicking” sound during mouth opening.Lateral movement improved significantly in patients who received laser therapy. In the patient control group,the click disappeared during mouth opening, the algometrically determined pain improved, and the lateralmovement increased. There were no statistically significant differences between groups in the improvementof vertical mouth movement or in the clicking sound during mouth closing. Conclusion: Each treatmentmodality applied in this study separately produced positive results for the clicking sound, restrictions in verticaland lateral movements, and reduction of the pressure pain threshold observed in cases of TMJ irregularity.In conclusion, the decision regarding which treatment modality should be employed can be made based onthe patient’s symptoms. However, this study also indicates that TMJ derangements can resolve spontaneouslywhen left untreated.