Natural course of temporomandibular disorders with low pain-related impairment: a 2-to-3-year follow-up study

To describe the natural course of temporomandibular disorders (TMD) in patients with low levels of pain-related impairment, independently by the physical diagnoses they received. Amongst all patients who attended the TMD Clinic, University of Padova, Italy, during the year 2009, those who: (i) had Research Diagnostic Criteria for TMD (RDC/TMD) axis II Graded Chronic Pain Scale (GCPS) grade 0 or 1 scores, (ii) received counselling on their signs and symptoms at the time of their first visit and suggestions on how to self-manage their symptoms, (iii) did not attend the Clinic since the time of their last visit and (iv) were visited by the same resident, were recalled for a follow-up assessment during the period from September to December 2011. Sixty-nine patients (79% females; mean age 47.4 ± 11.3 years; range 26-77) of 86 who were potentially eligible accepted to enter the study. The time span since the first visit ranged from 23 to 36 months. At the follow-up assessment, the percentage of patients with muscle disorders decreased from 68.1% to 23.1%; disc displacement with reduction remained unchanged (52.1%), whilst the 5.7% of patients who had disc displacement without reduction with limited opening then showed absence of limitation; diagnoses related to other joint disorders decreased from 30.4% to 14.4% for arthralgia and from 27.5% to 24.6% for osteoarthritis/osteoarthrosis. In a sample of patients TMD with low pain-related impairment followed up with a single recall assessment at 2-to-3 years, the natural course of disease was generally favourable