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Comparative study of repositioning splint therapy and passive manual range of motion techniques of anterior displaced temporomandibular discs with unstable excursive reduction [with consumer summary]
Carmeli E, Sheklow SL, Bloomenfeld I
Physiotherapy 2001 Jan;87(1):26-36
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: The purpose of this study was to compare two treatment methods. Mobilisation with active exercises, and soft repositioning splinting, as treatment protocols for relief of symptoms secondary to anterior displaced temporomandibular disc (ADTMD) syndrome. METHODS: Thirty-six individuals between 19 and 43 years old with ADTMD participated in this study. Eighteen patients were chosen randomly to receive four weeks of treatment with a soft repositioning splint, and the other 18 received passive mobilization and active exercises. All subjects were assessed for active range of motion for maximum mouth opening and pain levels, which were measured according to the pain physiopathology instrument, before and after treatment. RESULTS: The manual mobilization with exercises group demonstrated a significant decrease in total pain level (p < 0.05), and improved mouth opening (p < 0.05). The soft repositioning splint group failed to show significant change in either variable. CONCLUSION: This study suggests that manual mobilization and active exercises are more effective for treatment of pain and range of motion deficits associated with ADTMD, than soft respositioning splint therapy. These improvements do not necessarily mean that the disorder is cured.

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