Manipulative reduction combined with functional training for the treatment of acute anterior disc displacement without reduction / 中华物理医学与康复杂志

ABSTRACT

Objective:To evaluate the efficacy of combining modified manipulative reduction with functional training for the treatment of acute anterior disc displacement without reduction.Methods:Sixty anterior disc displacement patients aged from 19 to 55 years were randomly divided into an experimental group and a control group, each of 30. The experimental group was given modified manipulative reduction, while the control group was provided with traditional manipulative reduction. After the manipulative reduction, both groups received 3 months of functional training. Visual analog scale (VAS) ratings, maximum active mouth opening, a mandibular movement index and magnetic resonance imaging (MRI) were employed before and immediately after the reduction and after the functional training to evaluate their effectiveness. An oral health-related quality of life scale was also used. The number of attempts needed to achieve successful reduction and the overall success rate were compared between the two groups.Results:There was significant improvement in the average VAS ratings, maximum active mouth opening, mandibular movement index and oral health-related life quality of both groups after the experiment. Immediately after reduction, the maximum active mouth opening and mandible movement in the experimental group were significantly higher than in the control group, on average. Further improvement was observed after the treatment such that there was no significant difference between the two groups. After the functional training, however, the experimental group′s average VAS and oral health-related life quality scores were significantly better than the control group′s averages. According to MRI right after reduction, the success rate of the experimental group (96.7%) was significantly better than among the control group (80%). After the functional training the corresponding values were 86.7% and 73.3%. That difference was no longer significant. There was also no significant difference in the number of attempts needed to achieve successful reduction.Conclusion:The modified manipulative reduction not only has a higher success rate, but also can immediately improve mouth opening and mandible mobility. Combined with functional training, it can effectively reduce pain and improve life quality.