Comparision of Primary Treatments for TMJ Closed Lock without Osteoarthritis ITT Analysis
Purpose: The aim of this study was to evaluate primary treatment in the patients with disk displacement without reduction and no osseous changes. Subjects and Methods: The improvement proportion during three months after onset of treatment was compared in the four groups, 1st group, intraoral a dmin...
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| Published in | Journal of the Japanese Society for the Temporomandibular Joint Vol. 9; no. 2; pp. 343 - 355 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Temporomandibular Joint
20.09.1997
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-3004 1884-4308 |
| DOI | 10.11246/gakukansetsu1989.9.343 |
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| Abstract | Purpose: The aim of this study was to evaluate primary treatment in the patients with disk displacement without reduction and no osseous changes. Subjects and Methods: The improvement proportion during three months after onset of treatment was compared in the four groups, 1st group, intraoral a dministration of non steroidal anti inflammatory drug (NSAIDs): 2nd group, NSAIDs and mounth opening exercise: 3rd group, arthrocente sis: 4th group, a combination of arthrocentesis and a single injection of steroid. The subjects analyzed totaled 99 patients consiting of 25 in 1st group, 23 in 2nd group, 28 in 3rd group, and 23 in 4th group. Result: The improvement rate was 40% in 1st group, 44% in 2nd group, 36% in 3rd grop, and 30% in 4th group. Conlusion: In terms of improvement rate, no significance was found among 4 groups. However, a combination of intraoral administration of NSAIDs and mouth opening exercise could be most appropriate when primary treatment for TMJ closed lock without OA is evaluated. |
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| AbstractList | Purpose: The aim of this study was to evaluate primary treatment in the patients with disk displacement without reduction and no osseous changes. Subjects and Methods: The improvement proportion during three months after onset of treatment was compared in the four groups, 1st group, intraoral a dministration of non steroidal anti inflammatory drug (NSAIDs): 2nd group, NSAIDs and mounth opening exercise: 3rd group, arthrocente sis: 4th group, a combination of arthrocentesis and a single injection of steroid. The subjects analyzed totaled 99 patients consiting of 25 in 1st group, 23 in 2nd group, 28 in 3rd group, and 23 in 4th group. Result: The improvement rate was 40% in 1st group, 44% in 2nd group, 36% in 3rd grop, and 30% in 4th group. Conlusion: In terms of improvement rate, no significance was found among 4 groups. However, a combination of intraoral administration of NSAIDs and mouth opening exercise could be most appropriate when primary treatment for TMJ closed lock without OA is evaluated. |
| Author | OGI, Nobumi MAKI, Izumi YUASA, Hidemichi ITO, Yutaka TOYAMA, Masahiko KURITA, Kenichi ARIJI, Eiichiro |
| Author_xml | – sequence: 1 fullname: OGI, Nobumi organization: The Second Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: MAKI, Izumi organization: The Second Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: KURITA, Kenichi organization: The Second Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: YUASA, Hidemichi organization: Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: ITO, Yutaka organization: The Third Department of Prosthetic Dentistry, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: ARIJI, Eiichiro organization: Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University – sequence: 1 fullname: TOYAMA, Masahiko organization: Department of Oral and Maxillofacial Radiology, School of Dentistry, Aichi-Gakuin University |
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| References | 6) Stegenga, B., de Bont, L. G. M. et al: Short-term outcome of arthroscopic surgery of temporomandibular joint osteoarthrosis and internal derangement: a randomized controlled clinical trial. Br J Oral Maxillofac Surg 31: 3-14, 1993. 7) Schiffman, E. L.: The role of the randomized clinical trial in evaluating managent stragies for temporomandibular disorders. Fricton, J. R., Dubner, R., et al; Orofacial Pain and Temporomandibular disorders (Advance in Pain Research and Therapy, Vol 21), 1st ed, Raven Press Ltd, New York, 1995, p. 415-463. 19) 浜島信之, 湯浅秀道: インフォームドコンセント, 鶴尾 隆, 西條長宏編; 今日の癌化学療法3, 初版, 中外医学社, 東京, 1996, 371-375頁. 12) 折笠秀樹: 治療しようとした全症例での統計解析 -intention-to-treatの原理-. 日本医事新報 3571: 62-66, 1992. 21) 成田幸憲, 栗田賢一, 他: クローズドロックの臨床所見の検討 第3報 顎関節腔洗浄療法の評価. 日顎誌 6: 544-555, 1994. 32) Murakami, K., Hosaka, H. et al: Short-term treatment outcome study for the management of temporomandibular joint closed lock. A comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage. Oral Surg Oral Med Oral Pathol 80: 253-257, 1995. 5) Dimitroulis, G., Dolwick, M. F. et al: Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg 33: 23-27, 1995. 24) 湯浅秀道, 栗田賢一, 他: クローズドロックの臨床所見の検討 第1報 未治療片側性症例の初診時所見について. 日顎誌 3: 345-352, 1991. 15) 神野洋輔, 栗田賢一, 他: クローズドロック症例におけるパンピングマニュピュリーション施行例の円板形態による検討 (抄). 日顎誌 6: 228, 1994. 20) 湯浅秀道, 栗田賢一, 他: 若年者における最大開口域と年齢との関係. 口科誌 45: 416-422, 1996. 28) 栗田賢一, Westesson, P-L., 他: クローズドロックの臨床所見の検討 第2報 自然経過観察群の初診後6, 12カ月時の臨床症状. 日顎誌 5: 415-426, 1993. 16) 竹中 誠, 伊藤 裕, 他: 顎関節雑音症例に対する下顎前方整位型スプリントを作製する治療位について. 日顎誌 5: 311-319, 1993. 22) Nitzan, D. W., Dolwick, M. F. et al: Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg 49: 1163-1167, 1991. 30) Freedman, D., Pisani, R. et al: Design of Experiments. Freedman, D., Pisani, R. et al; Statistics, 2nd ed, W W Norton & Company, Inc., New York, 1991. p3-25. 2) 和気祐之, 木野孔司, 他: クローズドロックを示した顎関節症に対する保存療法の経験. 日口外誌 33: 1677-1683, 1987. 17) 浜島信之: がん臨床研究におけるインフォームドコンセント: 私論. 日顎治 31: 99-66, 1996. 4) 宮島智房, 甲斐貞子, 他: 整位不能な復位のない関節円板前方転位症例に対する保存療法の結果. 日顎誌 6: 247-259, 1994. 9) Bertolami C. N., Gay, T, et al: Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 51: 232-242, 1993. 10) 吉澤信夫, 柴田考典, 他: 顎関節症に対するSI-6601A (ヒアルロン酸ナトリウム関節注入製剤) の臨床的有用性の検討 第3報: 臨床第III相試験. 日顎誌 6: 515-531, 1994. 8) Lundh, H., Westesson, P-L. et al: Temporomandibular joint disk displacement without reduction. Treatment with flat occlusal aplint versus no treatment. Oral Surg Oral Med Oral Pathol 73: 655-658, 1992. 31) 浜島信之, 湯浅秀道: がん化学療法の比較検討のための統計学. 吉田清一監修; がん化学療法の副作用対策, 初版, 先端医学社, 東京, 1996, 558-564頁. 33) Sebastian, M. H. and Moffett, B. C.: The effects of continuous passive motion on the temporomandibular joint after surgery. Part II. Appliance improvement, normal subject evaluation, pilot clinical trial. Oral Surg Oral Med Orad Pathol 67: 644-653, 1989. 3) 松下 健, 高木律男, 他: クローズド・ロック症例 (非ロック解除例) に対する開口練習の効果. 日顎誌 7: 345-354, 1995. 1) Kirk, W. S. Jr. and Calabrese, D. K.: Clinical Evaluation of Physical Therapy in the Management of Internal Derangement of the Temporomandibular Joint. J Oral Maxillofac Surg 47: 113-119, 1989. 25) 大橋靖雄, 浜田知久馬: 打切り. 大橋靖雄, 浜田知久馬; 生存時間解析 SASによる生物統計, 初版, 東京大学出版会, 東京, 1195, 11-14頁. 26) SAS Institute Inc: The ANOVA Procedure. SAS Institute Inc, SAS/STAT user's guide, version 6., SAS Institute Inc, North Carolina, 1990, p209-244. 18) 下山正徳, 江口研二, 他: 臨床試験計画 (プロトコール) の作成と実施, 並びに結果の統計解析とその評価に関するガイドライン (改訂第3版) 第11部 がん臨床試験のインフォームド・コンセントの指針. 癌の臨床 42: 339-352, 1996. 34) Segami N., Murakami, K. et al: Arthrographic evaluation of disk position following mandibular manipulation technique for internal derangent with closed lock of the temporomandibular joint. J Craniomandib Disord 4: 99-108, 1990. 14) Tasaki, M. M., Westesson, P-L.: Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology 186: 723-729, 1993. 13) 下山正徳, 田島絹子, 他: 臨床試験計画 (プロトコール) の作成と実施, 並びに結果の統計解析とその評価に関するガイドライン (改訂第3版) 第1部 プロトコールの作成に関する医学的並びに科学的事項とその審査. 癌の臨床 42: 197-229, 1996. 29) 折笠秀樹: ランダム化はなぜ重要か?. 折笠秀樹著; 臨床研究デザイン 医学研究における統計入門. 初版, 真興交易, 東京, 1995, 56-59頁. 23) 浜島信之: 必要症例数の算定. 浜島信之, 無作為割付臨床試験, 初版, 癌と化学療法社, 東京, 1193, 60-83頁. 27) Clark, G. T.: A critical evalution of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness. JADA 108: 359-364, 1992. 11) Halvorsen, KT.: 独立な研究結果の併合-医学研究におけるメタアナリシスー. 津谷喜一郎, 折笠秀樹監訳, John C. Bailar, Fredrick Mosteller; 医学統計学の活用, 初版, サイエンティスト社, 東京, 1995, 329-345頁. |
| References_xml | – reference: 24) 湯浅秀道, 栗田賢一, 他: クローズドロックの臨床所見の検討 第1報 未治療片側性症例の初診時所見について. 日顎誌 3: 345-352, 1991. – reference: 3) 松下 健, 高木律男, 他: クローズド・ロック症例 (非ロック解除例) に対する開口練習の効果. 日顎誌 7: 345-354, 1995. – reference: 14) Tasaki, M. M., Westesson, P-L.: Temporomandibular joint: diagnostic accuracy with sagittal and coronal MR imaging. Radiology 186: 723-729, 1993. – reference: 23) 浜島信之: 必要症例数の算定. 浜島信之, 無作為割付臨床試験, 初版, 癌と化学療法社, 東京, 1193, 60-83頁. – reference: 32) Murakami, K., Hosaka, H. et al: Short-term treatment outcome study for the management of temporomandibular joint closed lock. A comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage. Oral Surg Oral Med Oral Pathol 80: 253-257, 1995. – reference: 33) Sebastian, M. H. and Moffett, B. C.: The effects of continuous passive motion on the temporomandibular joint after surgery. Part II. Appliance improvement, normal subject evaluation, pilot clinical trial. Oral Surg Oral Med Orad Pathol 67: 644-653, 1989. – reference: 5) Dimitroulis, G., Dolwick, M. F. et al: Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg 33: 23-27, 1995. – reference: 22) Nitzan, D. W., Dolwick, M. F. et al: Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg 49: 1163-1167, 1991. – reference: 1) Kirk, W. S. Jr. and Calabrese, D. K.: Clinical Evaluation of Physical Therapy in the Management of Internal Derangement of the Temporomandibular Joint. J Oral Maxillofac Surg 47: 113-119, 1989. – reference: 25) 大橋靖雄, 浜田知久馬: 打切り. 大橋靖雄, 浜田知久馬; 生存時間解析 SASによる生物統計, 初版, 東京大学出版会, 東京, 1195, 11-14頁. – reference: 4) 宮島智房, 甲斐貞子, 他: 整位不能な復位のない関節円板前方転位症例に対する保存療法の結果. 日顎誌 6: 247-259, 1994. – reference: 28) 栗田賢一, Westesson, P-L., 他: クローズドロックの臨床所見の検討 第2報 自然経過観察群の初診後6, 12カ月時の臨床症状. 日顎誌 5: 415-426, 1993. – reference: 26) SAS Institute Inc: The ANOVA Procedure. SAS Institute Inc, SAS/STAT user's guide, version 6., SAS Institute Inc, North Carolina, 1990, p209-244. – reference: 29) 折笠秀樹: ランダム化はなぜ重要か?. 折笠秀樹著; 臨床研究デザイン 医学研究における統計入門. 初版, 真興交易, 東京, 1995, 56-59頁. – reference: 21) 成田幸憲, 栗田賢一, 他: クローズドロックの臨床所見の検討 第3報 顎関節腔洗浄療法の評価. 日顎誌 6: 544-555, 1994. – reference: 2) 和気祐之, 木野孔司, 他: クローズドロックを示した顎関節症に対する保存療法の経験. 日口外誌 33: 1677-1683, 1987. – reference: 10) 吉澤信夫, 柴田考典, 他: 顎関節症に対するSI-6601A (ヒアルロン酸ナトリウム関節注入製剤) の臨床的有用性の検討 第3報: 臨床第III相試験. 日顎誌 6: 515-531, 1994. – reference: 13) 下山正徳, 田島絹子, 他: 臨床試験計画 (プロトコール) の作成と実施, 並びに結果の統計解析とその評価に関するガイドライン (改訂第3版) 第1部 プロトコールの作成に関する医学的並びに科学的事項とその審査. 癌の臨床 42: 197-229, 1996. – reference: 17) 浜島信之: がん臨床研究におけるインフォームドコンセント: 私論. 日顎治 31: 99-66, 1996. – reference: 18) 下山正徳, 江口研二, 他: 臨床試験計画 (プロトコール) の作成と実施, 並びに結果の統計解析とその評価に関するガイドライン (改訂第3版) 第11部 がん臨床試験のインフォームド・コンセントの指針. 癌の臨床 42: 339-352, 1996. – reference: 20) 湯浅秀道, 栗田賢一, 他: 若年者における最大開口域と年齢との関係. 口科誌 45: 416-422, 1996. – reference: 12) 折笠秀樹: 治療しようとした全症例での統計解析 -intention-to-treatの原理-. 日本医事新報 3571: 62-66, 1992. – reference: 34) Segami N., Murakami, K. et al: Arthrographic evaluation of disk position following mandibular manipulation technique for internal derangent with closed lock of the temporomandibular joint. J Craniomandib Disord 4: 99-108, 1990. – reference: 16) 竹中 誠, 伊藤 裕, 他: 顎関節雑音症例に対する下顎前方整位型スプリントを作製する治療位について. 日顎誌 5: 311-319, 1993. – reference: 8) Lundh, H., Westesson, P-L. et al: Temporomandibular joint disk displacement without reduction. Treatment with flat occlusal aplint versus no treatment. Oral Surg Oral Med Oral Pathol 73: 655-658, 1992. – reference: 15) 神野洋輔, 栗田賢一, 他: クローズドロック症例におけるパンピングマニュピュリーション施行例の円板形態による検討 (抄). 日顎誌 6: 228, 1994. – reference: 19) 浜島信之, 湯浅秀道: インフォームドコンセント, 鶴尾 隆, 西條長宏編; 今日の癌化学療法3, 初版, 中外医学社, 東京, 1996, 371-375頁. – reference: 6) Stegenga, B., de Bont, L. G. M. et al: Short-term outcome of arthroscopic surgery of temporomandibular joint osteoarthrosis and internal derangement: a randomized controlled clinical trial. Br J Oral Maxillofac Surg 31: 3-14, 1993. – reference: 30) Freedman, D., Pisani, R. et al: Design of Experiments. Freedman, D., Pisani, R. et al; Statistics, 2nd ed, W W Norton & Company, Inc., New York, 1991. p3-25. – reference: 9) Bertolami C. N., Gay, T, et al: Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 51: 232-242, 1993. – reference: 31) 浜島信之, 湯浅秀道: がん化学療法の比較検討のための統計学. 吉田清一監修; がん化学療法の副作用対策, 初版, 先端医学社, 東京, 1996, 558-564頁. – reference: 27) Clark, G. T.: A critical evalution of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness. JADA 108: 359-364, 1992. – reference: 11) Halvorsen, KT.: 独立な研究結果の併合-医学研究におけるメタアナリシスー. 津谷喜一郎, 折笠秀樹監訳, John C. Bailar, Fredrick Mosteller; 医学統計学の活用, 初版, サイエンティスト社, 東京, 1995, 329-345頁. – reference: 7) Schiffman, E. L.: The role of the randomized clinical trial in evaluating managent stragies for temporomandibular disorders. Fricton, J. R., Dubner, R., et al; Orofacial Pain and Temporomandibular disorders (Advance in Pain Research and Therapy, Vol 21), 1st ed, Raven Press Ltd, New York, 1995, p. 415-463. |
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| Subtitle | ITT Analysis |
| Title | Comparision of Primary Treatments for TMJ Closed Lock without Osteoarthritis |
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