Clinical assessment of the pumping technique in treating TMJ arthrosis with closed lock.

The treatment of closed jaw locking due to temporomandibular joint (TMJ) arthrosis is described. Conventional mandibular manipulation of the lower and/or upper joint compartments was performed using hydraulic pressure from an imaging X-ray medium. The procedure was used in 40 patients with closed locking (5 acute and 35 chronic). The results of the treatment are evaluated and factors affecting the results are examined. In four of the five patients with acute closed locking, the lock was successfully released after use of the pumping technique on the lower joint compartment. In patients with chronic locking, an average improvement of 6.6 mm in the degree of interincisal opening was observed within 3-4 days of treatment with the pumping technique. In 13 of these patients, satisfactory opening (at least 40 mm) was achieved immediately. All the patients underwent further forward and contralateral manipulation to assist mouth opening, and after a period of 2-3 months 16 patients showed a further average improvement of 5.4 mm in interincisal opening.