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Lu C, Zhao J, Zhang X, Fan X, Nie X, Yu C, Yang C, He D. Comparison of disc position stability and condylar bone remodeling between two open disc repositioning surgeries: a retrospective single-center cohort study. Int J Surg 2024; 110:01279778-990000000-01003. [PMID: 38241415 PMCID: PMC11020046 DOI: 10.1097/js9.0000000000001129] [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: 10/06/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND OBJECTIVE Open suturing (OSu) and Mini-screw Anchor (MsA) are two commonly used open disc repositioning surgeries for anterior disc displacement (ADD) of the temporomandibular joint (TMJ). This study assesses the differences in disc position stability (DPS) and condylar bone remodeling (CBR) between these two surgical procedures in a single center. METHODS A retrospective cohort study using magnetic resonance imaging (MRI) scans (preoperation, 1 week and 12 mo postoperation) of all patients who had open TMJ disc repositioning surgery from January 2016 to June 2021 at one center through two surgical techniques (OSu and MsA) was performed. The predictor variable was technique (OSu and MsA). Outcome variables were DPS and CBR. During follow-up, DPS was rated as good, acceptable and poor, and CBR was graded as improved, unchanged, and degenerated. Multivariate analysis was used to compare the DPS and CBR at 12 months after adjusting 5 factors including age, sex, Wilkes stage, preoperative bone status (normal, mild/moderate abnormal) and the degree of disc repositioning (normal, overcorrected, and posteriorly repositioned). Relative risk (RR) for DPS and CBR was calculated by multivariate logistic regression. RESULTS 385 patients with 583 joints were included in the study. MRIs at 12 months showed that 514 joints (93.5%) had good DPS, and 344 joints (62.5%) had improved CBR. Multivariate analysis revealed that OSu had higher DPS (RR=2.95; 95% confidence interval [CI], 1.27 to 6.85) and better CBR (RR=1.58; 95%CI, 1.02 to 2.46) than MsA. Among the factors affecting DPS, females had better results than males (RR=2.63; 95%CI, 1.11 to 6.26) and overcorrected or posteriorly repositioned discs were more stable than normally-repositioned discs (RR=5.84; 95%CI, 2.58 to 13.20). The improvement in CBR decreased with age increasing (RR=0.91; 95%CI, 0.89 to 0.93). Preoperative mild/moderate abnormal bone status had a higher probability of improved CBR compared to normal preoperative bone status (RR=2.60; 95%CI, 1.76 to 3.83). CONCLUSION OSu had better DPS and CBR than MsA. Sex and the degree of disc repositioning impacted DPS, while age and preoperative bone status affected CBR.
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Affiliation(s)
- Chuan Lu
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Jieyun Zhao
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xiaoyu Zhang
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xingda Fan
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine. Shanghai, China
| | - Chuangqi Yu
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Chi Yang
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Dongmei He
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
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Zou L, Yang K, Yu Y, Wang C, Zhao J, Lu C, He D. Analysis of joint protein expression profile in anterior disc displacement of TMJ with or without OA. Oral Dis 2024. [PMID: 38251222 DOI: 10.1111/odi.14871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/09/2023] [Accepted: 01/07/2024] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Anterior disc displacement (ADD) is a common clinical issue and may cause osteoarthritis (OA). However, the research of protein changes in synovial fluid as disease development marker and potential treatment clue is still insufficient. MATERIALS AND METHODS We conducted the high-resolution mass spectrometry (MS) of synovial fluid collected from 60 patients with normal disk position to ADD and ADD with osteoarthritis (OA). The proteins with significant changes among the 3 groups were analyzed by biological information and further validated by in primary rat condyle chondrocytes and OA animal model. RESULTS FGL2, THBS4, TNC, FN1, OMD etc. were significantly increased in ADD without OA (p < 0.05), which reflected the active extracellular matrix and collagen metabolism. FGFR1, FBLN2, GRB2 etc. were significantly increased in ADD with OA group (p < 0.05), which revealed an association with apoptosis and ferroptosis. Proteins such as P4HB, CBLN4, FHL1, VIM continuously increase in the whole disease progress (p < 0.05). Both the in vitro and in vivo results are consistent with protein changes detected in MS profile. CONCLUSION This study firstly provides the expression changes of proteins from normal disc condyle relationship toward ADD with OA, which can be selected and studied further as disease progress marker and potential treatment targets.
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Affiliation(s)
- Luxiang Zou
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Kaiwen Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Yeke Yu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Chuyao Wang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Jieyun Zhao
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Chuan Lu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
| | - Dongmei He
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- National Clinical Research Center of Stomatology, Shanghai, China
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Sun J, Zhu H, Lu C, Zhao J, Nie X, Yang Z, He D. Temporomandibular joint disc repositioning and occlusal splint for adolescents with skeletal class II malocclusion: a single-center, randomized, open-label trial. BMC Oral Health 2023; 23:694. [PMID: 37759222 PMCID: PMC10537145 DOI: 10.1186/s12903-023-03402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and dentofacial deformities combined with and without postoperative occlusal splints (POS) has not been well studied. OBJECTIVE This study was to evaluate and compare the effects of OSu with and without POS in the treatment of TMJ anterior disc displacement without reduction (ADDwoR) in adolescent skeletal Class II malocclusion. METHODS A total of 60 adolescents with bilateral ADDwoR were enrolled in this study. They were randomly allocated into two groups: OSu with and without POS. Magnetic resonance imaging (MRI) and lateral cephalometric radiographs were used to measure changes in condylar height and the degree of skeletal Class II malocclusion from before operation and at 12 months postoperatively. Changes in these indicators were compared within and between the two groups. RESULTS After OSu, both groups exhibited significant improvements in condylar height and occlusion at the end of 12 months follow-up (P < 0.05). The group of OSu with POS had significantly more new bone formation (2.83 ± 0.75 mm vs. 1.42 ± 0.81 mm, P < 0.001) and improvement in dentofacial deformity than the group of OSu only (P < 0.05). The new bone height was significantly correlated with POS (P < 0.001), the changes of SNB (P = 0.018), overjet (P = 0.012), and Wits appraisal (P < 0.001). CONCLUSION These findings indicated that OSu can effectively stimulate condylar regeneration and improve skeletal Class II malocclusion in adolescents with bilateral ADDwoR. The results are better when combined with POS. TRIAL REGISTRATION This trial was prospectively registered on the chictr.org.cn registry with ID: ChiCTR1900021821 on 11/03/2019.
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Affiliation(s)
- Jiali Sun
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Huimin Zhu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Chuan Lu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jieyun Zhao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhi Yang
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Dongmei He
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Arthroscopic Disk Repositioning After Failed Open Disk Repositioning. J Craniofac Surg 2023; 34:e129-e134. [PMID: 35949030 DOI: 10.1097/scs.0000000000008867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 10/15/2022] Open
Abstract
PURPOSE Open disk repositioning has been long achieving excellent functional and stability outcomes. However, still remains some relapses for whom a second open surgery is often challenging. This study aimed to evaluate the effectiveness of arthroscopic disk reposition as an alternative surgery for unsuccessful cases of anterior disk displacement (ADD) after an initial open disk repositioning. MATERIALS AND METHODS This retrospective study included all patients who underwent secondary arthroscopy for disk repositioning of the relapsed ADD after an initial open surgery between January 2012 to June 2017. The redo arthroscopic disk repositioning and suturing procedure was the primary predictor input variable in this study. Outcome evaluation was based on both clinical (visual analog scale and maximal interincisal opening) and magnetic resonance imaging data. RESULTS Twenty-seven joints fulfilling the inclusion criteria were included. A significant improvement was detected at 24-month postoperatively compared with the baseline visual analog scale. The maximal interincisal opening showed a statistical improvement from 25.07 mm preoperatively to 38.44 mm at 24-month postoperatively. Twenty-six joints maintained a stable disk position with only 1 joint relapsed to ADD without reduction. CONCLUSION Arthroscopic disk reposition and suturing technique is a reliable and effective repeat surgery after failed initial open disk repositioning for management of ADD.
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Liu X, Yang Y, Chen L, Tian S, Abdelrehem A, Feng J, Fu G, Chen W, Ding C, Luo Y, Zou D, Yang C. Proteome Analysis of Temporomandibular Joint with Disc Displacement. J Dent Res 2022; 101:1580-1589. [PMID: 36267015 DOI: 10.1177/00220345221110099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Disc displacement without reduction is a common disorder of the temporomandibular joint, causing clinical symptoms and sometimes condylar degeneration. In some cases, bone regeneration is detected following disc-repositioning procedures. Until now, however, systems-wide knowledge of the protein levels for condylar outcome with disc position is still lacking. Here, we performed comprehensive expression profiling of synovial fluid from 109 patients with disc displacement without reduction using high-resolution data-independent acquisition mass spectrometry and characterized differences in 1,714 proteins. Based on magnetic resonance imaging, samples were divided into groups with versus without condylar absorption and subgroups with versus without new bone. For the proteomic analysis, 32 proteins in groups presented with statistical significance (>2-fold, P < 0.05). Pathways such as response to inorganic substances, blood coagulation, and estrogen signaling were significantly expressed in the group with bone absorption as compared with pathways such as regulation of body fluid levels, vesicle-mediated transport, and focal adhesion, which were enriched in the group without bone absorption. In subgroup analysis, 45 proteins of significant importance (>2-fold, P < 0.05) were associated with pathways including would healing, glycolysis and gluconeogenesis, and amino acid metabolism. Combined with clinical examination, molecules such as acetyl-CoA carboxylase beta (ACACB) and transforming growth factor beta 1 (TGFB1) were related to features such as visual analog scale and maximum interincisal opening (P < 0.05). In addition, 7 proteins were examined by Western blotting, including progesterone immunomodulatory binding factor 1 (PIBF1), histidine-rich glycoprotein (HRG), and protein kinase C and casein kinase substrate in neurons 2 (PACSIN2). In conclusion, this study provides the first proteome analysis of condylar absorption at disc displacement without reduction and postoperative new bone formation after disc reposition. Integrated with clinical data, this analysis provides an important insight into the proteomics of condylar modification at disc position.
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Affiliation(s)
- X Liu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Y Yang
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - L Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - S Tian
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - A Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - J Feng
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - G Fu
- Stomatology Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - W Chen
- Stomatology Hospital and College, Key Laboratory of Oral Diseases Research of Anhui Province, Anhui Medical University, Hefei, China
| | - C Ding
- State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Institute of Biomedical Sciences, Human Phenome Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Y Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - D Zou
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - C Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China
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Review of the studies on the relationship and treatment of anterior disc displacement and dentofacial deformity in adolescents. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:470-474. [PMID: 36229365 DOI: 10.1016/j.oooo.2022.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/17/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022]
Abstract
Anterior disk displacement (ADD) is a common type of temporomandibular joint (TMJ) internal derangement. In adolescents, the relationship between ADD and dentofacial deformities are brought into focus. Whether treatment is needed, or what kind of treatment are effective are still without a consensus. From the literature review, the consequences of ADD without treatment and the effect on disk repositioning were summarized. The results showed that after ADD, condylar height was prone to reduce that may lead to or aggravate dentofacial deformities in adolescents. Disk repositioning could promote the regeneration of condylar bone, thus improving the development of dentofacial deformities.
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Sah MK, Abdelrehem A, Chen S, Shen P, Jiao Z, Hu YK, Nie X, Yang C. Prognostic indicators of arthroscopic discopexy for management of temporomandibular joint closed lock. Sci Rep 2022; 12:3194. [PMID: 35210483 PMCID: PMC8873273 DOI: 10.1038/s41598-022-07014-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 11/09/2022] Open
Abstract
In order to optimize patient selection for temporomandibular joint (TMJ) arthroscopic discopexy to achieve favorable outcomes, prognostic indicators impacting the results are important to analyze. This longitudinal retrospective study aimed to analyze various prognostic factors impacting surgical outcomes following arthroscopic discopexy for management of TMJ closed lock using success criteria based on pain, maximal interincisal opening, diet, and quality of life. Furthermore, a quantitative MRI assessment was performed pre- and post-operatively. Multivariate analysis was used to evaluate various prognostic variables including gender, age, side, duration of illness, Wilkes staging, parafunctional habits, splint therapy and orthodontic treatment. A total of 147 patients (201 joints) were included. The outcome was categorized as excellent (n = 154/76.61%), good (n = 34/16.91%), or poor (n = 13/6.46%) with a success rate of 93.54%. Patients aged > 30 years old (p = 0.048), longer duration of illness (12–24 months: p = 0.034) and (> 24 months: p = 0.022), and patients with Wilkes stage IV (p = 0.002) were all significantly more likely to be in the poor outcome group. Finally, orthodontic treatment showed a significant association with excellent outcomes (p = 0.015). Age, duration of illness, Wilkes staging, and orthodontic treatment are considered significant prognostic factors that can predict the outcomes following the arthroscopic discopexy for management of TMJ closed lock.
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Affiliation(s)
- Manoj Kumar Sah
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Ahmed Abdelrehem
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & 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
| | - Shihui Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - ZiXian Jiao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Ying Kai Hu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. .,College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
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Liu X, Abdelrehem A, Zheng J, Luo Y, Yang C. An arthroscopic technique for closure of perforations in temporomandibular joint retrodiscal tissues. Int J Oral Maxillofac Surg 2021; 51:669-676. [PMID: 34580001 DOI: 10.1016/j.ijom.2021.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 05/19/2021] [Accepted: 08/02/2021] [Indexed: 11/29/2022]
Abstract
The objective of this retrospective study was to introduce and evaluate an arthroscopic discopexy for closure of retrodiscal tissue perforations. A total of 112 patients (135 joints) receiving an arthroscopic discopexy for management of retrodiscal tissue perforations between January 2016 and September 2019 were included. Pre- and postoperative visual analogue scale (VAS) pain scores and maximum inter-incisal opening (MIO), as well as magnetic resonance imaging (MRI) data, were collected and analysed. Success was recorded when the disc position was >11 o'clock, VAS pain score <3, and MIO>25 mm. For patients with a condyle deformity, postoperative bone remodelling was also recorded. The VAS pain score decreased from 3.04 ± 2.66 preoperatively to 0.88 ± 1.13 at 12 months postoperatively (P < 0.001) and MIO increased from 33.90 ± 7.39 mm to 35.19 ± 6.14 mm (P = 0.029). MRI evaluation revealed that 133 discs were successfully repositioned back on top of the condyle. Among these, 11 joints were associated with either VAS pain score ≥3 or MIO ≤25 mm. Therefore, a success rate of 90.4% (122/135) was achieved at 12 months postoperative. Bone remodelling was detected in 72 joints. Arthroscopic discopexy is a minimally invasive and effective treatment for retrodiscal tissue perforations that achieves the purpose of simultaneously restoring the intra-articular structures and relieving clinical symptoms.
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Affiliation(s)
- X Liu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - A Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - J Zheng
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Y Luo
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - C Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
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The Effect of Condylar Regeneration After Different Disc Repositioning Surgeries in Adolescents with Skeletal Class II Malocclusion. J Oral Maxillofac Surg 2021; 79:1851-1861. [PMID: 33901450 DOI: 10.1016/j.joms.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the effect of different temporomandibular joint (TMJ) disc repositioning surgeries for the treatment of anterior disc displacement (ADD) in juvenile patients with skeletal Class II malocclusion. PATIENTS AND METHODS Patients (< 20 years, cervical vertebral maturation stage, IV-V) who had bilateral TMJ ADD with skeletal Class II malocclusion were treated by disc repositioning surgery (mini-screw anchor, [MsA]; or opening suturing, [OSu]). Magnetic resonance imaging (MRI) and lateral cephalometric films before and more than 12 months after surgery were collected from all patients. Changes of SNA, SNB, ANB, incisor overjet, pogonion position (pg'-G'), and condylar height were measured before and after surgery in different disc reposition surgeries and compared by statistical analysis. RESULTS Eighty-four patients with an average age of 16.44 years and follow-up time of 14.60 months (12 to 33 months) were included in the study. Among them, 16 patients had a mean follow-up of 14.8 months without treatment before disc repositioning. Their condylar height was significantly decreased (P = .004) by MRI measurement. Six patients who had cephalometric films showed significantly decreased SNB (P = .042) and increased overjet (P = .037). After disc repositioning by either OSu (54 cases) or MsA (30 cases), condylar height, SNB were significantly increased and overjet, Pg'-G', ANB were decreased in both groups (P < 0.001). There was more new bone height in OSu than MsA (P = .004), but no significant differences in SNB, ANB, overjet and Pg'-G' between the 2 groups (P > .05). The new bone height was significantly correlated with the surgical method (P = .029), age (P = .015), SNB (P = .008), overjet (P = .048) and pg'-G' (P = .001). CONCLUSIONS Both types of disc repositioning method can effectively promote condylar regeneration and improve skeletal Class II malocclusion in adolescents with ADD. Disc repositioning by OSu obtained more new bone height than MsA.
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Arthroscopic versus open disc repositioning and suturing techniques for the treatment of temporomandibular joint anterior disc displacement: 3-year follow-up study. Int J Oral Maxillofac Surg 2021; 50:1351-1360. [PMID: 33750641 DOI: 10.1016/j.ijom.2021.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 11/21/2022]
Abstract
The aim of this study was to evaluate the outcomes of temporomandibular joint (TMJ) arthroscopic and open disc repositioning procedures in the management of anterior disc displacement (ADD). All consecutive patients treated with arthroscopic (group I) or open (group II) disc repositioning between April 2014 and August 2018 were included prospectively. The patients were assessed clinically (1, 3, 6, 12, 24, and 36 months postoperative) and with magnetic resonance imaging (MRI). The statistical analysis was performed using IBM SPSS Statistics v.22.0; P < 0.05 was considered significant. A total of 177 patients (227 joints) were included: 104 patients (130 joints) in group I and 73 patients (97 joints) in group II. There were statistically significant improvements in pain score, clicking, quality of life, diet, and maximum inter-incisal opening when comparing pre- and postoperative clinical parameters within the two groups (P < 0.05 at all time-points for all clinical parameters); however, improvements occurred earlier in group I (at 1 month) than in group II (6 months). Postoperative MRI revealed an overall success rate of 98.1% in group I and 97.3% in group II. New bone formation was found in 70.2% in group I and 30.1% in group II. Arthroscopy may be a better choice for ADD patients, with the advantages of faster clinical improvement and recovery, minimal invasiveness, and better condylar remodelling.
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Dong M, Jiao Z, Sun Q, Tao X, Yang C, Qiu W. The magnetic resonance imaging evaluation of condylar new bone remodeling after Yang's TMJ arthroscopic surgery. Sci Rep 2021; 11:5219. [PMID: 33664376 PMCID: PMC7933332 DOI: 10.1038/s41598-021-84591-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 01/12/2021] [Indexed: 12/30/2022] Open
Abstract
To evaluate the post-operative condylar bone remodeling after the treatment of Yang's arthroscopic surgery. Consecutive cases from Jan 2017 to May 2018 that received Yang's arthroscopic surgery were included in this study, the TMJ MRI examinations were performed preoperatively and postoperatively (follow up for 1 year or more), and condylar bone remodeling was estimated. A total of 229 patients (29 male and 200 female) were included in the study, 161 patients had new bone formation, and the average age was 17.5 ± 2.1a. There was no new bone formation in 68 patients with an average age of 24.5 ± 0.7a. The percentage of new bone formation patients in 10-15 years of age was 94.33% and decreases as the age increases. In the position of new bone formation, the posterior slope of condyle was the most (129 joints), the second was the top of condyle (54 joints), the third was around condyle (33 joints), only 25 joints had new bone on the anterior slope of condyle. After TMJ arthroscopic surgery, the condyle has the ability to form new bone, and the younger the age, the stronger the ability of new bone formation. The formation of new bone was most in posterior slope and least in anterior slope of condyle.
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Affiliation(s)
- Minjun Dong
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Zixian Jiao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Qi Sun
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
| | - Weiliu Qiu
- Department of Oral Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
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Functional orthodontics after arthroscopic disk repositioning in adolescent anterior disk displacement with mandibular retrusion. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:357-362. [DOI: 10.1016/j.oooo.2020.04.811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/09/2020] [Accepted: 04/21/2020] [Indexed: 12/17/2022]
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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
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