Treatment of severe temporomandibular joint clicking with botulinum toxin in the lateral pterygoid muscle in two cases of anterior disc displacement

Introduction. The displacement of the articular disc with reduction in the temporomandibular joints (TMJ) is a disorder with complex and multifactorial aetiology requiring adequate treatment. According to the authors of many studies, increased tension and a direct attachment of muscle fibers of the upper part of the lateral pterygoid muscle to the articular disc increase the likelihood of the disorder. The treatment of choice is conservative, including increasingly frequent intramuscular injections of botulinum toxin. By blocking the secretion of acetylcholine in the neuromuscular plate Botox causes a reverse tension reduction or complete paralysis of the upper part of the lateral pterygoid muscle. In consequence, it may lead to the return of the disk to the right place in the TMJ with the simultaneous decrease of clinical symptoms in patients. Aim. To perform a systematic review of treatments for the anterior articular disc displacement using botulinum toxin. Material and Methods: For the preparation work, the available databases: PubMed, Google Scholar, OVID and Embase were used. Original papers published in the last twenty years, in Polish and English, using the key words: botulinum toxin, the displacement of the articular disc, were searched. Results and conclusions. The current state of knowledge and results of studies in the literature suggest that botulinum toxin is suitable for the treatment of anterior articular disc displacement.

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Stress analysis in human temporomandibular joint affected by anterior disc displacement during prolonged clenching

Journal of Oral Rehabilitation ◽

10.1111/joor.12036 ◽

2013 ◽

Vol 40 (4) ◽

pp. 239-246 ◽

Cited By ~ 13

Author(s):

S. Abe ◽

F. Kawano ◽

K. Kohge ◽

T. Kawaoka ◽

K. Ueda ◽

...

Keyword(s):

Stress Analysis ◽

Temporomandibular Joint ◽

Disc Displacement ◽

Anterior Disc Displacement

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Management of Internal Derangement of Temporomandibular Joint Disc Displacement with Reduction Using Two Different Lines of Treatment

Brazilian Dental Science ◽

10.14295/bds.2021.v24i2.2080 ◽

2021 ◽

Vol 24 (2) ◽

pp. 8

Author(s):

Mohamed Ahmed Helal ◽

Shoroog Hassan Agou ◽

Amr Bayoumi ◽

Ahmed Imam ◽

Ali Habiballah Hassan

Keyword(s):

Range Of Motion ◽

Temporomandibular Joint ◽

Lower Cost ◽

Internal Derangement ◽

Disc Displacement ◽

Temporomandibular Joint Disc ◽

Non Invasive ◽

Anterior Disc Displacement ◽

Disc Displacement With Reduction

Objetive: This study was to compare the effectiveness of arthrocentesis versus the insertion of anterior repositioning splint (ARS) in improving the mandibular range of motion (MRM) for patients with the temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDwR). Methods: 36 patients diagnosed as ADDwR were recruited and divided randomly into two groups. The first group (G1) was treated by arthrocentesis, and the second (G2) was treated using ARS. All patients were reexamined after six months. Results: Except that for protrusive movement, there were significant differences between the two groups for the percentage changes of the MRM as measured by the amount of pain free opening, unassisted opening, maximum assisted opening, right lateral and left lateral movements (p < 0.05). Conclusion: Within the context of the current study, the non-invasive, lower cost ARS, provided better results in improving the MRM when managing ADDwR cases. Keywords Arthrocentesis; Anterior repositioning splint; TMD; Internal derangement; Anterior disc displacement; Mandibular range of motion.

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