Long-term outcomes of nonsurgical treatment in nonreducing anteriorly displaced disk of the temporomandibular joint

The aim of this study was to evaluate long-term outcomes of nonsurgical treatment in patients with persistent anterior disk displacement without reduction of the temporomandibular joint.Thirty-five patients were treated with occlusal splints, and 12 patients underwent additional occlusal treatments after splint treatment. These patients were evaluated clinically and radiographically. At least 2 years after the treatment, the 34 patients' symptoms were assessed with the use of a questionnaire.The mean maximal interincisal distance (MID) was 27.6 mm before treatment and 44.4 mm at the end of treatment (p < 0.001). Before the treatment, all 35 patients had complained of pain, and mild pain persisted in 9 patients at the end of treatment. Flattening of the condylar head and of the articular eminence increased in prevalence from 12.1% and 9.1%, respectively, before treatment to 54.5% and 51.5%, respectively, at the time of follow-up observation. At the time of the survey, the mean self-reported MID was 46.8 mm (p < 0.01).After the nonsurgical treatment, the clinical signs and symptoms improved significantly, although the prevalence of osteoarthrotic findings increased.