Ny Tran Thi Nguyen, Viet Hoang, Khanh An Phung, Hung Lam Tran
Department of Fundamental Dentistry, Faculty of Dentistry, Van Lang University, Ho Chi Minh City, Vietnam.
Department of Orthodontics and Pedodontics, Faculty of Dentistry, Van Lang University, Ho Chi Minh City, Vietnam.
Medicine (Baltimore). 2025 Sep 5;104(36):e44011. doi: 10.1097/MD.0000000000044011.
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.
本研究探讨了接受运动疗法治疗的颞下颌关节内紊乱患者的症状、临床特征以及诸如前伸运动矢状面髁突路径角度和长度等特征的变化。根据颞下颌关节紊乱病（DC/TMD）轴I的诊断标准选择并分类患者。治疗性运动计划包括每日进行的侧方颌运动，并逐渐增加至每日50次重复的目标。评估包括患者报告的结果，如使用视觉模拟量表评估的颌部疼痛、颌部弹响不适以及颌运动时的不适，以及临床医生评估的结果，包括颌运动幅度、关节弹响以及触诊时的疼痛或压痛。使用快速轴面描记法评估前伸运动时的髁突路径。在治疗前、治疗后4周和8周进行评估。大多数患者为可复性盘移位（61.1%，n = 22），近一半患者双侧颞下颌关节均有问题（47.2%，n = 17）。根据患者评估，在8周期间，左右两侧的疼痛程度、颌部弹响和颌运动均持续且显著降低（P <.05）。8周后左右侧方运动显示出显著改善，表明运动对侧方颌运动有积极影响（P <.05）。然而，最大开口度和前伸的测量在8周内无显著变化（P >.05）。运动疗法有效缓解了颞下颌关节内紊乱患者的症状和临床特征。
