Evaluation of mandibular condylar movement exercise for patients with internal derangement of the temporomandibular joint on initial presentation.

The aim of the present study was to evaluate mandibular condylar movement in a group of Japanese women who presented with closed lock of the temporomandibular joint. A total of 148 women aged between 19 and 75 years were included in the study. We examined mouth-opening, protrusion, and lateral excursive movements, and divided the patients into two groups (74 experimental cases and 74 controls). The experimental group was treated with exercises of the mandibular condyle, and the median (range) maximum mouth-opening increased from 27 (range 11-34)mm to 38 (24-47)mm. In control cases, it increased from 29 (range 20-35)mm to 30 (20-39)mm without exercise. In the experimental group, the median (range) maximum lateral movement on the opposite (unaffected) side increased from 8 (3-12)mm to 9 (5-13)mm. In the control group it remained similar at 7 (3-12)mm and 7 (3-12)mm. In the experimental group, the median (range) lateral movement on the affected side increased from 6 (2-13)mm to 8 (3-13)mm. In controls it remained similar at 6 (2-12)mm and 6 (2-12)mm. In the experimental group, the median (range) maximum protrusion increased from 6 (3-12)mm to 7 (4-12)mm, and in the control group from 6 (2-10)mm to 7 (2-10)mm. There was a significant difference between the experimental (50/74, 68%) and control groups (3/74, 4%) in the degree of increased mouth-opening. Exercise of the first mandibular condylar seems to be useful in the treatment of closed lock on initial treatment.