Randomized clinical trial of primary treatment for temporomandibular joint disk displacement without reduction and without osseous changes: A combination of NSAIDs and mouth-opening exercise versus no treatment

Objective. The effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy for disk displacement without reduction is unknown. This study compared this treatment method with nontreatment controls. Methods. Sixty patients with painful disk displacement without reduction and without osseous changes were randomly divided in 2 groups, consisting of NSAID and physical therapy and a nontreated control group. Both groups were observed at 2 weeks and, for those patients who did not show any improvement, again at 4 weeks. Results. There was 60% improvement in the treatment group compared with 33% in the control group during the entire 4 weeks of the study. The number needed to treat for benefit was 3.75, with a 95% CI 2.103 to 65.935. Conclusions. A combination of NSAID and physical therapy for 4 weeks is effective as a primary treatment of patients with disk displacement without reduction and without osseous changes.