Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
J Oral Rehabil. 2013 Feb;40(2):139-58. doi: 10.1111/joor.12016. Epub 2012 Nov 30.
To describe the scientific literature about the diagnosis, prevalence, aetiology, natural course and possible treatment modalities of disc displacements within the temporomandibular (TM) joint. PubMed was searched for specific indexing terms. The search yielded 1211 papers. After screening according to title and abstract, 695 papers were excluded, and after full-text reading, 107 papers remained. Hand-searching of the reference lists resulted in an extra 47 papers. Thirteen studies, published since the literature search was carried out, were also included, resulting in 167 papers for this review. A disc displacement is a highly prevalent derangement within the TM joint, with reported prevalence ranging from 18% to 35% in the general population. A disc displacement with reduction is mostly a stable, pain-free and lifelong condition of the joint. In only a small minority of patients, the disc loses its capacity to reduce on opening. Surprisingly, only in rare cases, the loss of disc reduction is accompanied by signs and symptoms of a closed lock (viz. a painful and limited mouth opening). These signs and symptoms have a tendency to reduce and in many cases to resolve within months. The favourable natural course of disc displacements only warrants active treatment for symptomatic disc displacements without reduction. The primary treatment option is a conservative, non-surgical treatment focusing at speeding up the natural process of alleviation of pain and of improvement in mouth opening. For most patients, a disc displacement is just a pain-free, lifelong lasting, 'noisy annoyance' from their TM joint.
描述颞下颌（TM）关节中盘移位的诊断、流行率、病因、自然病程和可能的治疗方法的科学文献。在 PubMed 上搜索特定的索引术语。搜索产生了 1211 篇论文。根据标题和摘要进行筛选后，排除了 695 篇论文，全文阅读后，仍有 107 篇论文保留。对参考文献列表进行手工搜索，又额外增加了 47 篇论文。自文献检索以来发表的 13 项研究也包括在内，因此本综述共包含 167 篇论文。盘移位是 TM 关节中一种高发的紊乱，在普通人群中的流行率报告范围为 18%至 35%。可复性盘前移位大多是关节的一种稳定、无痛和终身状态。只有一小部分患者的关节在开口时失去了复位的能力。令人惊讶的是，只有在极少数情况下，盘复位的丧失伴有闭锁（即疼痛和受限的张口）的迹象和症状。这些迹象和症状有减轻的趋势，在许多情况下，在数月内会得到缓解。盘移位的有利自然病程仅需要对有症状且无复位的盘移位进行积极治疗。主要的治疗选择是保守的非手术治疗，重点是加速缓解疼痛和张口改善的自然过程。对于大多数患者来说，盘移位只是 TM 关节无痛、终身持续、“无声的烦恼”。
