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.