Evaluating the Effect of Conservative Therapy in Patients with Wilkes Stage III Temporomandibular Joint Derangement

The authors evaluated effects of physiotherapy in patients experiencing Wilkes III temporomandibular joint (TMJ) derangement with clinically limited joint mobility, but no pain. The group consisted of 31 patients with unilateral temporomandibular joint involvement, 3 men and 28 women (average age was 30.93, ranging from age 12 to 61). None of the patients in the group had experienced any previous TMJ therapy. The patients underwent conservative therapy in the form of home exercise (mobilisation and isometric exercises) as the first step in treatment. The authors evaluated the improvement in jaw movement (maximal interincisal opening - MIO) and the patients' subjective assessments of their condition. Disc position before and after two months of exercise was also evaluated using ultrasound examination. The average MIO value in patients before starting the exercises was 33.5 mm, and after two months of exercises, 42.4 mm. Subjective assessment by patients: 26 patients (83%) described their condition as completely satisfactory, not requiring further therapy. Of these patients, ultrasound examination showed 10 patients with complete disc reduction, 9 patients with a change in disc displacement with reduction, and 7 patients with a continuing (unchanged) state of disc displacement. Results of our study show the effect of conservative therapy in patients with painless TMJ due to disc displacement (WIII). Effect of home exercises which were easy to perform, simple and acceptable to the patient were demonstrated.