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Modified condylotomy versus conventional conservative treatment in painful reciprocal clicking—a preliminary prospective study in eight patients

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Abstract

Modified condylotomy may be relevant in severe painful reciprocal clicking of the temporomandibular joint (TMJ) where conservative treatment is insufficient. The effect of the modified condylotomy was analyzed and compared with conventional nonsurgical treatment in a randomized pilot study of eight patients, 19–44 years of age, with severe painful reciprocal clicking. Before and after treatment, assessments were performed by subjective reports, clinical recordings, and blinded evaluations of radiography and magnetic resonance imaging (MRI). Based on the clinical evaluations before treatment, all conditions were disc displacements with reduction and arthralgia (Research diagnostic criteria for temporomandibular disorders), but based on MRI, one patient had disc displacement without reduction and another had normal disc position. The treatment effect was significantly better and the disorders were significantly more reduced with condylotomy than with conventional nonsurgical treatment (P < 0.05, Mann–Whitney U test). In the surgical group, the clicking and locking had disappeared, the pain during function was significantly reduced (P < 0.05, Friedman ANOVA), and in two patients the disc position was normalized. The clicking still persisted in the nonsurgical patients and the disc position was unchanged. Our conclusion is that modified condylotomy is a promising option to reduce symptoms and signs in severe painful reciprocal clicking.

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Acknowledgement

The authors appreciate the surgical assistance rendered by Professor Søren Hillerup, DDS, Ph.D., Dr. Odont, Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark. The study was supported by The Danish Dental Association (Calcinfonden). The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Oral Medicine, Clinical Oral Physiology, Oral Pathology and Anatomy, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, 20 Nörre Allé, 2200, Copenhagen, Denmark

    Merete Bakke & Niels Max Thorsen

  2. Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, University of Malmö, Malmö, Sweden

    Lars Eriksson

  3. Department of Oral and Maxillofacial Surgery, University Hospital, Malmö, Sweden

    Lars Eriksson

  4. Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark

    Lars Eriksson

  5. Department of Radiology, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    Ib Sewerin

  6. Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden

    Arne Petersson

  7. Department of Neuroradiology, Copenhagen University Hospital, Copenhagen, Denmark

    Aase Wagner

Authors
  1. Merete Bakke
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  2. Lars Eriksson
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  3. Niels Max Thorsen
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  4. Ib Sewerin
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  5. Arne Petersson
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  6. Aase Wagner
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Correspondence to Merete Bakke.

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Bakke, M., Eriksson, L., Thorsen, N.M. et al. Modified condylotomy versus conventional conservative treatment in painful reciprocal clicking—a preliminary prospective study in eight patients. Clin Oral Invest 12, 353–359 (2008). https://doi.org/10.1007/s00784-008-0204-x

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  • DOI: https://doi.org/10.1007/s00784-008-0204-x

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