Outcome of conservative treatments in patients with TMJ retrodiscal layer rupture or disc perforation

This study was aimed to investigate the efficacy of comprehensive conservative treatments in patients with temporomandibular joint (TMJ) retrodiscal layer rupture and/or disc perforation.

This was a retrospective study of thirty-one consecutive patients with findings of TMJ retrodiscal layer rupture and/or disc perforation using magnetic resonance imaging. Comprehensive stomatognathic system assessments were performed. Comprehensive treatment modalities were applied to each patient and treatment outcomes were analyzed. The changes in patient-reported symptoms and comfortable mouth opening (CMO) and maximum mouth opening (MMO) distances were analyzed between the baseline and after treatment.

Twenty-eight females and three males were included in this study. Four patients (12.9%) reported a history of facial injury and another four (12.9%) reported having rheumatoid arthritis. Unilateral chewing was the most frequently reported parafunctional habit, followed by clenching. The mean treatment duration was 24.3 ± 11.1 months. Most of the patients received more than one type of treatment. Both CMO and MMO distances increased significantly (P < 0.001) after treatment. Approximately three-quarters of patients reported partial improvement in symptoms, and one-fourth reported complete improvement.

Comprehensive conservative treatments were effective and should be applied first in patients with TMJ retrodiscal layer rupture and/or disc perforation.

Conservative treatments are recommended for patients with severe damage to the TMJ structures, such as retrodiscal layer rupture and/or disc perforation, before applying surgical approach.