Aim: We describe a series of five cases presented with disc displacement with reduction and intermittent lock (DDwRIL), from presentation to follow-up.
Background: Disc displacement with reduction with intermittent lock is a temporomandibular disorder in which the disc is displaced and reduced, along with temporary locking leading to limited opening. Due to the fact that it has only been recognized as a separate disease in 2013, there is no clear guideline on the management of these cases.
Cases descriptions: We present five cases of clinically established DDwRIL in different age groups. We walk through clinical presentation and diagnostic workup. Several modalities were used in the management of described cases from noninterventional management with counselling only to physical and splint therapies.
Conclusion: Disc displacement with reduction, with intermittent locking is a challenging temporomandibular disorder with risk to progress into disc displacement without reduction and hence necessitates a tailored approach and long-term follow-up.
Clinical significance: To our knowledge, this is the first case series reported on DDwRIL which provides detailed clinical presentation, examination, management, and discussion for orofacial pain practitioners as well as for future studies on this disease.
De Rossi SS, Greenberg MS, Liu F, et al. Temporomandibular disorders. Med Clin North Am 2014;98(6):1353–1384. DOI: 10.1016/j.mcna.2014.08.009
Naeije M, te Veldhuis AH, te Veldhuis EC, et al. Disc displacement within the human temporomandibular joint: a systematic review of a ‘noisy annoyance.’ J Oral Rehabil 2013;40(2):139–158. DOI: 10.1111/joor.12016
Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache 2014;28(1):6–27. DOI: 10.11607/jop.1151
Wilkes CH. Internal derangements of the temporomandibular joint: pathological variations. Arch Otolaryngol - Head Neck Surg 1989;115(4):469–477. DOI: 10.1001/archotol.1989.01860280067019
Kalaykova S. Temporomandibular joint internal derangements: diagnosis, mechanisms and risk factors, and prognosis. 2010
Young A. Internal derangements of the temporomandibular joint: a review of the anatomy, diagnosis, and management. J Indian Prosthodont Soc 2015;15(1):2–7. DOI: 10.4103/0972-4052.156998
Al-Moraissi EA, Wolford LM, Ellis E, et al. The hierarchy of different treatments for arthrogenous temporomandibular disorders: a network meta-analysis of randomized clinical trials. J Cranio-Maxillofacial Surg 2020;48(1):9–23. DOI: 10.1016/j.jcms.2019.10.004
Yoda T, Sakamoto I, Imai H, et al. Response of temporomandibular joint intermittent closed lock to different treatment modalities: a multicenter survey. Cranio® 2006;24(2):130–136. DOI: 10.1179/crn.2006.020
Kalaykova S, Lobbezoo F, Naeije M. Riskfactors for anterior disc displacement with reduction and intermittent locking in adolescents. J Orofac pain headache 2011;25(2):153–160. http://www.quintpub.com/journals/ofph/full_txt_pdf_alert.php?article_id=10706)
Poluha RL, Canales GD la T, Costa YM, et al. Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. J Appl Oral Sci 2019;27:e20180433. DOI: 10.1590/1678-7757-2018-0433
Kalaykova S, Lobbezoo F, Naeije M. Two-year natural course of anterior disc displacement with reduction. J Orofac Pain 2010;24(4):373–378. http://www.quintpub.com/journals/ofph/abstract.php?article_id=10306)
Yamaguchi T, Komatsu K, Okada K, et al. The advantageous direction of jaw movement for releasing TMJ intermittent lock. Cranio® 2006;24(3):171–178. DOI: 10.1179/crn.2006.028
Lee M-O, Lee Y-H, Kang S-K, et al. Relationships between intermittent locking history and self-reported bruxism in temporomandibular joint. J Oral Med Pain 2017;42(2):29–34. DOI: 10.14476/jomp.2017.42.2.29
Kalaykova S, Lobbezoo F, Naeije M. Effect of chewing upon disc reduction in the temporomandibular joint. J Orofac Pain 2011;25(1):49–55. http://www.quintpub.com/journals/ofph/abstract.php?article_id=10415)
Kohli MR, Yamaguchi M, Setzer FC, et al. Spectrophotometric analysis of coronal tooth discoloration induced by various bioceramic cements and other endodontic materials. J Endod 2015;41(11):1862–1866. DOI: 10.1016/j.joen.2015.07.003
Nishigawa K, Nakano M, Ishikawa T, et al. Case report of recurrent temporomandibular joint open lock associated with abrupt reduction of displaced articular disk. J Prosthodont Res 2014;58(3):184–190. DOI: 10.1016/j.jpor.2014.04.001
Manfredini D, Guarda-Nardini L, Winocur E, Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(4):453–462. DOI: 10.1016/j.tripleo.2011.04.021