Effects of therapeutic exercise in patients with internal derangement of the temporomandibular joint: A prospective study.

This study examines the symptomatic and clinical features and variations in characteristics, such as angle and length of the condylar path in the sagittal plane during protrusion movement, in internal derangement patients treated with exercise therapy. Patients were selected and classified using the diagnostic criteria for temporomandibular disorders (DC/TMD) axis I. The therapeutic exercise program consisted of lateral jaw movements performed daily, with gradual progression to a target of 50 repetitions per day. Assessments included both patient-reported outcomes - such as jaw pain, discomfort from jaw sounds, and discomfort during jaw movements using the visual analogue scale and clinician-evaluated outcomes, including jaw movement amplitude, joint sounds, and pain or tenderness upon palpation. The condylar path during protrusive movement was evaluated using quick axis axiography. Assessments were conducted before treatment, and at 4- and 8-weeks posttreatment. Most patients underwent disc displacement with reduction (61.1%, n = 22) and nearly half of patients had issues in both TMJs (47.2%, n = 17). There was a consistent and significant reduction in pain levels, jaw sound, and jaw movement over the 8-week period for both the right and left sides (P < .05) according to patients' assessment. The right and left lateral excursions show significant improvements after 8 weeks, suggesting that exercises had a positive effect on lateral jaw movements (P < .05). However, the measurements for maximum mouth opening and protrusion showed no significant changes over 8 weeks (P > .05). Exercise therapy effectively relieved symptomatic and clinical characteristics in patients with internal derangement.