顎関節症に対する保存治療の変化による症状改善効果

DOI 被引用文献4件 参考文献22件
  • 木野 孔司
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 杉崎 正志
    東京慈恵会医科大学歯科学教室
  • 羽毛田 匡
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 高岡 美智子
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 太田 武信
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 渋谷 寿久
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 佐藤 文明
    東京医科歯科大学大学院医歯学総合研究科顎顔面頸部機能再建学系顎顔面機能修復学講座顎顔面外科学分野
  • 儀武 啓幸
    東京医科歯科大学大学院医歯学総合研究科顎顔面頸部機能再建学系顎顔面機能修復学講座顎顔面外科学分野
  • 石川 高行
    東京医科歯科大学大学院医歯学総合研究科全人的医療開発学系包括診療歯科学講座顎関節咬合学分野
  • 田辺 晴康
    東京慈恵会医科大学歯科学教室
  • 吉田 奈穂子
    東京慈恵会医科大学歯科学教室
  • 来間 恵里
    東京慈恵会医科大学歯科学教室
  • 成田 紀之
    日本大学松戸歯学部顎咬合治療学講座

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  • The improvement of treatment outcomes by changing a therapeutic approach for temporomandibular disorders

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In the past decade, the strategy in conservative treatment for TMDs has markedly changed in our clinic.<BR>Recently, we are actively using physical exercise to treat temporomandibular disorders (TMDs), and instruction for self-correction of habitual behavior. Management of psychological contributing factors such as anxiety and depression is simultaneously conducted individually.<BR>Through our clinical experiences using the above-mentioned therapy, it has appeared that recent post-treatment outcomes have been better than with the previous treatment strategy for TMDs.<BR>In this study, treatment results obtained from 363 TMD patients in 2003 were compared with 382 patients in 1993 in order to confirm the difference between the two periods and to consider the future treatment tactics for TMDs.<BR>In 1993, NSAIDs, oral appliances, mouth opening exercise and disc repositioning manipulation were used to treat TMDs. On the other hand, corrective instruction for each behavioral contributing factor observed in patients, manipulative mobilization under anesthesia of TMJ, administration of anti-anxiety agents or anti-depressants and consultation with psychosomatic medicine were newly adopted in 2003.<BR>As a result, the treatment cases by means of mobilization exercise and NSAIDs administration increased, while the cases by means of oral appliances and the disc repositioning manipulation reduced in 2003. Based on the outcome criteria used at the investigation in 1993, the excellent rate showed a significantly (p<0.001) larger value in 2003 (61.0%) than in 1993 (39.8%). In contrast, the treatment period significantly (p=0.030) decreased from 11.5 weeks in 1993 to eight weeks in 2003.<BR>These results suggested that detecting and correcting the contributing factors of TMDs may be effective for the treatment of TMD patients, and further study to verify the effects of exercise therapy needs to be carried out in the near future.

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