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Journal of Orofacial Pain

Year 1989
Volume 3 , Issue 1

Pages: 35 - 43

The Intracapsular Therapeutic Modalities in Cojunction with Arthrography: Case Reports


Manipulation and lavage of the temporomandibular joint has been shown to add an important therapeutic dimension to arthrography. These therapeutic modalities were prescribed by the primary treating practitioner in conjunction with diagnostic arthrography in a group of patients. The therapeutic modalities consisted of joint mobilization (Farrar manipulation or distraction) augmented by (1) increased hydraulic pressure in the superior compartment, or (2) with small amounts of contrast in both compartments, and/or (3) with lavage of the superior joint compartment. The therapeutic modalities were prescribed in association with the arthrography as a logical extension of the arthrographic technique. The result of the mobilization and lavage was an increase in the mandibular range of motion (ROM) and a decrease in pain in cases with adhesions as well as those with anteriorly displaced disks without reduction. Patients with anteriorly displaced disks with reduction, redundant tissue in the fossa, osteochondritis, and adhesive capsulitis also showed benefit, although patient populations treated with these conditions were small. There we re no adverse sequelae. Manipulation and lavage should now be viewed as one more tool in the treatment of intracapsular pathology.


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