To the Editor.—Marbach and Lipton state in the February Archives (1982;108:102-107) that "bite adjustment had no advantage over placebo" in the treatment of temporomandibular joint (TMJ) syndrome. Weinberg1 recommends occlusal adjustments as one of the treatment objectives. Other authors2 also recommend occlusal adjustment for successful adjunctive treatment of TMJ dysfunction.
Marbach and Lipton also state that a bite adjustment appliance "functions essentially as placebo." The reference for that statement was an article written in 1972. More recent articles recommend the use of treatment prostheses.3-7
Finally, the authors advised that surgery be performed in patients having ankylosis. In fact, multiple articles advise the use of surgery in TMJ disturbances causing pain (eg, perforation of a disk, chronic synovitis, flattening of the articular eminence,8 osteomyelitis,9 condylar exostosis,10 and synovial chondromatosis11).
Temporomandibular dysfunction still presents a problem in diagnosis and treatment. Arthrography is just coming into play
ALBERT RW. Temporomandibular Joint Syndrome. Arch Otolaryngol. 1983;109(3):199. doi:10.1001/archotol.1983.00800170065018
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