Efficacy of therapeutic exercise for temporomandibular disorders as assessed by magnetic resonance imaging: a case report.
Yoshihiro Yamaguchi, Shigemitsu Sakuma, Shinya Takagi and 4 others
PMID 32753791WHAT IT FOUND
In one woman with acute jaw locking, four months of passive and active stretching increased mouth opening and allowed the jaw bone to move past a blockage seen on MRI.
The disc remained dislocated, but function improved.
Key findings
01After four months of treatment, MRI showed the mandibular condyle moved anteriorly and downwardly beyond the joint ridge during mouth opening, whereas it had not done so before treatment.
02The joint disc demonstrated forward dislocation both during opening and closing before and after the treatment, meaning the structural position of the disc did not change.
03The treatment combined passive range-of-motion exercises performed by a dentist with active self-traction therapy performed by the patient.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a single case report, so the findings cannot be generalized to other patients. The treatment involved two distinct components (passive therapist-led and active patient-led exercises), making it impossible to determine which part drove the improvement. There was no control group, so natural history or placebo effects cannot be ruled out. The structural pathology (disc dislocation) did not resolve, despite functional improvement.
Declared interests
No conflicts of interest were reported in the provided text.
The easy way to misread this
Do not conclude that therapeutic exercise repositions the displaced disc. The MRI showed the disc remained dislocated; the improvement was in the movement of the jaw bone and functional range of motion.