Introduction
Temporomandibular joint disorder (TMD) comprises a set of
musculoskeletal disorders that affect the temporomandibular joint (TMJ),
masticatory muscles and facial structures. Among the types of TMD, there
are internal derangements (ID), including articular disc displacement
without reduction (DDwoR).1 In DDwoR, the articular
disc is displaced anteriorly to the condyle and does not return to its
normal position during mandibular kinetics. Macro and microtraumas
represent the main causes of this condition, in which pain and
restriction of mandibular movements are the most frequent
symptoms.1,2
The absence of treatment or failure in therapeutic management results in
chronic displacement of the disc, leading to its deformation and
perforation, and to the rupture of the fibrocartilage that covers the
mandibular condyle and the articular fossa. Degeneration of joint
structures by DDwoR is associated with osteoarthritis of the
TMJ.3,4 The treatment of this condition consists of
conservative and surgical procedures, represented by manipulation,
medication, modification of habits, physiotherapy and splint therapy,
followed by arthrocentesis, arthroscopy and open joint surgery as a
second-step therapy, respectively.1,5,6
There are systematic reviews (SRs) comparing the effects of different
treatments, conservative and invasive, in the treatment of
DDwoR;7-12 however, there is no consensus on which
treatment is most effective and the quality of evidence on this issue
has not yet been established. Therefore, this overview aimed to
summarize the comparative effectiveness between different DDwoR
treatments and assess the quality of evidence from secondary studies
through different validated scales.