NATURAL COURSE OF UNTREATED SYMPTOMATIC TEMPOROMANDIBULAR-JOINT DISC DISPLACEMENT WITHOUT REDUCTION

In some patients with disc displacement without reduction, the symptom s of pain and decreased range of motion have been observed to resolve spontaneously over time without treatment. The natural history of this condition, however, is not well-understood. Thus, to study the natura l course of disc displacement without reduction, we followed 40 patien ts without treatment for a period of 2.5 years. The diagnosis was esta blished by history and physical examination and confirmed with magneti c resonance (MR) imaging. After 2.5 years, 43% of the patients were as ymptomatic, 33% had decreased symptoms, and 25% of the patients showed no improvement or had required treatment. MR evidence of osteoarthrit is and advanced stages of internal derangement at the initial evaluati on was associated with a poor prognosis. The result of this prospectiv e cohort study indicated that approximately 40% of patients with sympt omatic disc displacement without reduction will be free of symptoms wi thin 2.5 years, one-third will improve, whereas one-quarter will conti nue to be symptomatic. This knowledge should be valuable for the treat ment planning and evaluation of prognosis of patients with non-reducin g symptomatic disc displacement.