Therapeutic manipulation of the temporomandibular joint

We present a prospective study of manipulation of the temporomandibular joint (TMJ) under a general anaesthetic undertaken to find out the success rate in an effort to reduce the number of patients referred for invasive surgery.Results : Of the 55 patients invited to participate in this study, 15 improved, 15 did not, 6 showed partial improvement, and 19 were not treated. The median pre-treatment opening was 20mm (range 13–27). Among those who improved after manipulation, the median opening after treatment was 38mm (range 35–56). Some of those who improved experienced a return of TMJ clicking but not of joint or muscle tenderness. Conclusion: Manipulation under general anaesthesia helps some patients with disc displacement without reduction.