Nonsurgical management of internal derangements: a report of three cases.

AbstractThere is much difficulty involved in prescribing appropriate treatment for patients with internal derangements of the temporomandibular joint. This article presents three case histories in which the patients have well-documented TMJ disk displacements with and without perforations. None of these cases showed adequate response to extensive nonsurgical treatment, and all had come to the point of referral for surgical correction. While the doctors involved felt surgery to be the next step for relief, none of the patients actually went on for surgery. However, within a few months each showed significant improvement. Two to four years later the patients are still managing well without active treatments. These cases underscore the need to improve understanding of the course of internal derangements and of the efficacy of various treatment methods.