1
|
Heo HA, Park S, Pyo SW, Yoon HJ. Clinical outcomes of patients with unilateral internal derangement of the temporomandibular joint following arthrocentesis and stabilization splint therapy. Maxillofac Plast Reconstr Surg 2024; 46:24. [PMID: 38976106 PMCID: PMC11231121 DOI: 10.1186/s40902-024-00436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/02/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The management of internal derangement (ID) of the TMJ is challenging because of multiple etiologic factors and varying degrees of severity. The aim of this study was to evaluate the clinical outcomes of patients with unilateral ID treated with arthrocentesis and stabilization splint therapy during a 6-month period. METHODS A total of 105 patients (87 females, 18 males) with unilateral ID were included in this study. Patients were divided into unilateral anterior disc displacement with reduction (ADDwR) and unilateral anterior disc displacement without reduction (ADDwoR). Patients with ADDwoR were subdivided according to the erosive bone changes. Objective parameters on mandibular movement and subjective parameters on pain were obtained and assessed. Their clinical outcomes before and after arthrocentesis and stabilization splint therapy were compared with the chi-square, Fisher's exact test, paired t-test, or Wilcoxon singed-rank test. RESULTS All objective parameters of unilateral ID patients significantly increased at the 6-month follow-up. The differences in mean visual analog scale (VAS) pain scores were statistically significant in all subjective variables (p < 0.01). In joints with ADDwoR, preoperative maximal mouth opening, and maximal protrusive movement in both groups, with erosive and non-erosive changes were significantly increased after 6 months (p < 0.01). However, right and left maximal lateral movement increased after treatment in both groups but without significant differences. All VAS pain scores on jaw movement and palpation of associated muscles showed a significant decrease regardless of erosive changes. CONCLUSIONS The combination of arthrocentesis and subsequent stabilization splint therapy was shown to be highly effective in pain reduction and improvement of mandibular movements in both unilateral ADDwR and ADDwoR, as well as in cases with both erosive and non-erosive bony changes associated with unilateral ADDwoR.
Collapse
Affiliation(s)
- Hyun-A Heo
- Department of Advanced General Dentistry, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Suhyun Park
- Department of Advanced General Dentistry, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Woon Pyo
- Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Joong Yoon
- Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Bazsefidpay N, Ulmner M, Lund B. Did temporomandibular gap arthroplasty with temporalis interpositional flap improve function and pain in patients with end-stage joint disease? A 5-year retrospective follow-up. J Craniomaxillofac Surg 2024; 52:578-584. [PMID: 38368213 DOI: 10.1016/j.jcms.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/07/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
The primary aim of this study was to investigate whether patients with end-stage temporomandibular joint (TMJ) disease treated with gap arthroplasty with temporalis interpositional flap (GAT) had improved maximal interincisal opening (MIO) and TMJ pain in a long-term perspective. All patients with severe osteoarthritis, or fibrous or bony ankyloses, and subjected to GAT between 2008 and 2015 were included. The criteria of treatment success were TMJ pain VAS score ≤4 and MIO ≥30 mm. Reoperation was considered as a failure. Forty-four patients (mean age 47 years) were included in this retrospective descriptive case series and followed up for up to 7 years (mean 4.5). Comorbidities were frequent (n = 34) and most commonly rheumatic disease (n = 17). The indications for surgery were ankylosis (n = 32) or severe osteoarthritis (n = 12). Of the 44 included patients, 84% (n = 37) had a history of earlier TMJ surgery. The preoperative mean values for TMJ pain and MIO (VAS 7 and 23 mm, respectively) changed significantly (p < 0.001) to postoperative means of VAS 3 and 34 mm, respecitvely. The success rate was 59% (n = 26). When compared with a previous 2-year follow-up, the success rate was found to have decreased over time (p = 0.0097). The rate of successful treatment outcome in terms of MIO alone was 82% (n = 36). The most common reason for treatment failure was residual pain. In conclusion, the success-rate after GAT did not show long-term stability and continued to drop over time in this patient cohort. TMJ pain seems to be the main reason for failure.
Collapse
Affiliation(s)
- Nikoo Bazsefidpay
- Head-Neck and Plastic Surgery Clinic, Department of Oral and Maxillofacial Surgery, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Sweden.
| | - Mattias Ulmner
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Bodil Lund
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
3
|
de Souza-Pinto GN, Herreira-Ferreira M, Grossmann E, Brasil DDM, Hara GF, Groppo FC, Iwaki LCV. Assessment of temporomandibular joint bone changes associated with anterior disc displacement: An MRI cross-sectional study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101657. [PMID: 37866505 DOI: 10.1016/j.jormas.2023.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE This cross-sectional study aimed to evaluate the presence of bone changes on magnetic resonance imaging (MRI) scans of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) with reduction (ADDWR) and without reduction (ADDWoR). METHODS TMJ-MRI scans were screened for the presence of ADD. 285 scans presented ADD, being further divided into ADDWR (n = 188) and ADDWoR (n = 97). Bone changes on the mandibular condyle and articular eminence were also assessed and computed. The chi-square test compared the association of these bone changes with the presence of ADDWR and ADDWoR, with a significance level of 5 %. Also, the prevalence ratio (PR) was calculated. RESULTS In the mandibular condyle, subchondral cyst (p = 0.035, PR = 1.08) and bone edema (p = 0.044, PR = 2.40), more prevalent on ADDWR, and generalized sclerosis (p = 0.015, PR = 1.04), more prevalent on ADDWoR, presented significant association with ADD. On the articular eminence, generalized sclerosis (p = 0.015, PR = 1.04) and articular surface flattening (p = 0.003, PR = 1.19) presented significant association with ADD, both more prevalent on ADDWoR. CONCLUSION Bone changes are usual findings in TMJ with ADD diagnosis. The real influence of ADD is not fully clear, although clinicians should be aware of patients with this condition, to provide an early diagnosis and improve patient´s prognosis.
Collapse
Affiliation(s)
| | - Matheus Herreira-Ferreira
- Department of Dentistry, State University of Maringá, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Eduardo Grossmann
- Dentistry Faculty, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492- 90035-004, Porto Alegre, Brazil.
| | - Danieli de Moura Brasil
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
| | - Giovana Felipe Hara
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Francisco Carlos Groppo
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
| | | |
Collapse
|
4
|
Ananthan S, Pertes RA, Bender SD. Biomechanics and Derangements of the Temporomandibular Joint. Dent Clin North Am 2023; 67:243-257. [PMID: 36965929 DOI: 10.1016/j.cden.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The human temporomandibular joint, is a ginglymo-arthrodial joint. The articular disk serves as a fibrous, viscoelastic structure that allows force distribution and smooth movement of the joint in its normal arrangement during mandibular movements. Most studies suggest that in the normal disk position the posterior band is located at the 12'o clock position within the glenoid fossa in the closed mouth posture. When the biomechanics of the joint is altered, the disk may be displaced creating an abnormal relationship between the disk, condyle, and the eminence that is often referred to as an internal derangement. This article reviews the various presentations of internal derangements.
Collapse
Affiliation(s)
- Sowmya Ananthan
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders & Orofacial Pain, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07101, USA.
| | - Richard A Pertes
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders & Orofacial Pain, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07101, USA
| | - Steven D Bender
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Texas A & M Health, 3302 Gaston Avenue, Dallas, TX 75246, USA
| |
Collapse
|
5
|
Sah MK, Abdelrehem A, Chen S, Yang C. Arthroscopic discopexy versus natural course of temporomandibular joint anterior disc displacement: a longitudinal study of clinical and radiological outcomes. Int J Oral Maxillofac Surg 2022; 52:98-106. [PMID: 35810051 DOI: 10.1016/j.ijom.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
The aim of this study was to assess the various outcomes of arthroscopic discopexy compared to the natural course of anterior disc displacement (ADD) longitudinally in the same patients. A retrospective review was performed of 108 patients (152 joints) who experienced the natural course of ADD for a period of time and then underwent arthroscopic discopexy. The outcome was evaluated clinically and by magnetic resonance imaging. The natural course of ADD showed significant deterioration in pain, diet, and quality of life, and also a significant reduction in inter-incisal opening (all P < 0.001), while significant improvements in all clinical parameters were observed at the final postoperative follow-up (all P < 0.001, compared to the last preoperative visit). During the natural course, there was a significant shortening of condylar height, mandibular height, and disc length, and an increase in disc displacement distance (all P < 0.001). Postoperative follow-up revealed the restoration of condylar height and mandibular height, and all discs were significantly repositioned with an increased disc length (unfolded) (all P < 0.001). Bearing in mind the assumption of a low evidence base due to bias resulting from the retrospective non-double-blinded study design and the variable duration of the natural disease course prior to surgery, this study found that the natural course of ADD led to degenerative changes in the joint structures and clinical symptoms, whereas arthroscopic discopexy led to a restoration of the bony structures and the alleviation of clinical symptoms.
Collapse
Affiliation(s)
- M K Sah
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China
| | - A Abdelrehem
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China; Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - S Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China
| | - C Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China.
| |
Collapse
|
6
|
Matthews NS, Hechler BL, Shah R. Reprint of the role of total joint replacement surgery in the orthognathic patient. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
7
|
Silva MAG, Pantoja LLQ, Dutra-Horstmann KL, Valladares-Neto J, Wolff FL, Porporatti AL, Guerra ENS, De Luca Canto G. Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: A systematic review and meta-analysis. J Craniomaxillofac Surg 2020; 48:942-955. [PMID: 32896478 DOI: 10.1016/j.jcms.2020.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/01/2020] [Accepted: 08/16/2020] [Indexed: 12/15/2022] Open
Abstract
To assess the available literature on the prevalence of degenerative joint disease (DJD) in patients with anterior disc displacement (ADD) of the temporomandibular joint (TMJ), using a systematic review with meta-analysis. Search strategies were performed in the following databases: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO. A search was also carried out in the gray literature. Two independent reviewers selected the included articles using a two-phase process based on the eligibility criteria. Three reviewers independently collected the required information from the included articles. The methodological quality of the selected studies was assessed individually. In accordance with the inclusion and exclusion criteria, 1349 studies were found and 18 articles were included. The total sample size was 3158 TMJs. The sex distribution was predominant for females (1161 females and 345 males). The average age was 46 (range 10-82) years. Among the 1762 TMJs quantitatively assessed, the prevalence of DJD involving disc displacement with reduction (DDWR) was 35%, while for disc displacement without reduction (DDWoR) the prevalence was 66%. The prevalences of different features of DJD were as follows: sclerosis 24.3%, erosion 23.5%, osteophyte 17.9%, and subcortical cyst 7.6%. The prevalence of DJD in temporomandibular disorder patients with disc displacement is around 50% and is higher in DDWoR (66%) than in DDWR (35%). Sclerosis and erosion would be the most expected radiological signs in a developing DJD. Clinicians should adequately address the frequent DJD features associated with disc displacement in terms of diagnostics and therapeutic management.
Collapse
Affiliation(s)
- Maria Alves Garcia Silva
- Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | | | | | - José Valladares-Neto
- Department of Orthodontics, Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - André Luís Porporatti
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília, Brasília, Brazil
| | - Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| |
Collapse
|
8
|
Liu Z, Xie Q, Yang C, Chen M, Bai G, Abdelrehem A. The effect of arthroscopic disc repositioning on facial growth in juvenile patients with unilateral anterior disc displacement. J Craniomaxillofac Surg 2020; 48:765-771. [DOI: 10.1016/j.jcms.2020.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 04/21/2020] [Accepted: 05/27/2020] [Indexed: 12/26/2022] Open
|
9
|
Nguyen NGK, Nishiyama A, Shimada M. A rat model for inducing temporomandibular anterior disc displacement experimentally. J Oral Sci 2020; 62:70-74. [PMID: 31996527 DOI: 10.2334/josnusd.19-0093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to establish an experimental rat model of temporomandibular joint (TMJ) anterior disc displacement (ADD). A pilot study was conducted to determine the most appropriate surgical protocol. In the main experiment, 40 rats were used. Twenty-four rats were subjected to ADD in the right TMJ, and subsequently thereafter six, nine, and nine rats were sacrificed at 1, 4, and 8 weeks, respectively, for gross evaluation. Twelve rats that underwent a sham operation were equally divided and sacrificed at each of the above time points. Four non-treated control rats were sacrificed at the beginning of the study. TMJ blocks were harvested for radiological and histological assessment. Gross examination showed that 14 rats in the ADD group (58.3%) had anterior displacement of the TMJ disc. In the ADD joints, posterior condylar cartilage thickness decreased during the follow-up period; however, there was no significant difference between the sham-treated and ADD joints, or among the follow-up time points (P > 0.05). The anterior condylar cartilage exhibited obvious qualitative alterations. Radiologic signs of osteoarthrosis appeared after ADD surgery, but this became attenuated with time. The model investigated in this study successfully induced ADD in rats, and should be useful for assessment of progressive changes in the TMJ following ADD.
Collapse
Affiliation(s)
- Ngan G K Nguyen
- Orofacial Pain Management, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Akira Nishiyama
- Orofacial Pain Management, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Masahiko Shimada
- Orofacial Pain Management, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| |
Collapse
|
10
|
Heo HA, Yoon HJ. Clinical outcomes of patients with bilateral anterior disc displacement without reduction and erosive change of the temporomandibular joint after performance of unilateral arthrocentesis and stabilisation splint therapy. J Oral Rehabil 2019; 47:307-312. [PMID: 31557342 DOI: 10.1111/joor.12897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 08/21/2019] [Accepted: 09/24/2019] [Indexed: 11/27/2022]
Abstract
The efficacy of a combination treatment of arthrocentesis and stabilisation splint for patients with bilateral anterior disc displacement without reduction (ADDWoR) and erosive change of the TMJ remains controversial. To evaluate clinical outcomes of patients with ADDWoR and erosive change of the TMJ after performance of unilateral arthrocentesis and stabilisation splint therapy. A retrospective study of 44 patients (37 females, 7 males, mean age of 34 years) with bilateral ADDWoR and erosive change of the TMJ were included in this study. Their clinical outcomes before and after arthrocentesis and stabilisation splint therapy were compared. Evaluation criteria were as follows: (a) Maximal mouth opening (MMO); (b) Right and left maximal lateral movement (RLM, LLM) and maximal protrusive movement (PM); (c) Visual analog scale (VAS) pain score during MMO, RLM, LLM and PM; and (d) VAS pain score during palpation of masticatory muscles. Wilcoxon signed-rank test, Mc Nemar test and paired t test were used for statistical analysis. Differences in VAS pain score between arthrocentesis and non-arthrocentesis sites were not statistically significant except MMO and LLM (P < .05) after 6 months. Differences in mean VAS pain scores for all variables between before arthrocentesis and 6 months follow-up in the arthrocentesis site were statistically significant. (P < .01). Unilateral arthrocentesis on more symptomatic TMJ and subsequent stabilisation splint therapy was highly successful for pain and achievement of normal range of mandibular movements in patients with both ADDWoR and bony change.
Collapse
Affiliation(s)
- Hyun-A Heo
- Department of Advanced General Dentistry, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun-Joong Yoon
- Department of Oral and Maxillofacial Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
11
|
|
12
|
Emes Y, Bilici IŞ, Aybar B, Sancaklı E, Issever H, Yalcin S. Evaluation of occlusion types, pain severity, and onset of complaints in 127 patients with temporomandibular disorders: A retrospective study. Cranio 2018; 38:168-173. [PMID: 30153092 DOI: 10.1080/08869634.2018.1509824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: The aims of this study are to evaluate if occlusal types affect the type of temporomandibular disorders and if the onset of complaints are related to the type of internal derangements. Methods: One hundred thirty-four patients were evaluated. Occlusion types were grouped as Angle Class I, II, and III. The temporomandibular disorders were classified as masticatory muscle disorders, anterior disc dislocation with reduction, and anterior disc dislocation without reduction. Results: No significant relationships were found between the occlusion types, pain severity, the onset of the complaints, and the temporomandibular disorders. Premature contacts were found to be significantly higher in Class II and Class III patients, but no significant relations were found between premature contacts and temporomandibular disorders. Discussion: Occlusal features are not discriminant factors in the occurrence of temporomandibular disorders. Also, it cannot be concluded that the longer the patients have temporomandibular disorders, the higher their pain scores will be.
Collapse
Affiliation(s)
- Yusuf Emes
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Itır Şebnem Bilici
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Buket Aybar
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Erkan Sancaklı
- Faculty of Dentistry, Department of Prosthodontics, Istanbul University, İstanbul, Turkey
| | - Halim Issever
- Faculty of Medicine, Department of Public Health, Istanbul University, İstanbul, Turkey
| | - Serhat Yalcin
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| |
Collapse
|
13
|
Hu YK, Yang C, Xie QY. Changes in disc status in the reducing and nonreducing anterior disc displacement of temporomandibular joint: a longitudinal retrospective study. Sci Rep 2016; 6:34253. [PMID: 27671371 PMCID: PMC5037465 DOI: 10.1038/srep34253] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/08/2016] [Indexed: 11/21/2022] Open
Abstract
Treatment procedures for anterior disc displacement (ADD) of temporomandibular joint (TMJ) are far from reaching a consensus. The aim of the study was to evaluate disc status changes of anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR) comparatively, to get a better understanding of the disease progress without intervention. This longitudinal retrospective study included 217 joints in 165 patients, which were divided into ADDWR group and ADDWoR group based on magnetic resonance imaging (MRI) examination. The joints were assessed quantitatively for disc length and displacement distance at initial and follow-up visits. Disc morphology, which was classified in 5 types, was also evaluated. Paired t-test and Wilcoxon signed rank test were used to assess intra-group differences and independent t-test for inter-group differences. Moreover, analysis of covariance was applied to analyze influential factors for changes in disc length and displacement distance. According to our results, discs tended to become shorter, move further forward and distort more seriously in ADDWoR group than in ADDWR group after follow-up. Moreover, discs were prone to become shorter and more anteriorly displaced in teenagers, type I and III morphologies, advanced Wilkes stages, or those with joint effusion. Follow-up period seemed to be not critical.
Collapse
Affiliation(s)
- Ying Kai Hu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, Shanghai Key Laboratory of Stomatology, People's Republic of China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, Shanghai Key Laboratory of Stomatology, People's Republic of China
| | - Qian Yang Xie
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, Shanghai Key Laboratory of Stomatology, People's Republic of China
| |
Collapse
|