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.
Highlights
1) visited our clinic between January 2013 to December 2015 without sex or age restrictions; 2) had anterior disc displacement with reduction (ADDWR) or anterior disc displacement without reduction (ADDWoR) confirmed by MRI at first visit; 3) had 2 MRI records with an interval longer than 3 months
(6 for ADDWR turning into ADDWoR and 2 for poor MRI images), so the final total was 217 joints in 165
On basis of MRI, the present study evaluated the differences in changes in disc status, including disc length, position and morphology, between the ADDWR and ADDWoR groups through quantitative and qualitative measurements, as well as analyzing the factors influencing the changes in disc length and position relative to the condyle
Summary
1) visited our clinic between January 2013 to December 2015 without sex or age restrictions; 2) had ADDWR or ADDWoR confirmed by MRI at first visit; 3) had 2 MRI records with an interval longer than 3 months. 1) with ADDWR becaming ADDWoR after follow-up; 2) with poor image quality of MRI which was unsuitable for quantitative measurement, owing to movement by the patient when undergoing MRI. Several studies have examined the natural course of disc position and configuration in ADDWoR2,4,17–19, showing persistent existence of disc displacement, continued disc deformity and probably accelerated bone change. The purposes of this study were to quantitatively measure disc length, displacement distance, disc morphology between ADDWR and ADDWoR, as well as analyzing the influential factors of changes in disc status, to achieve more insights into the natural course of ADD of the TMJ. The authors hypothesized that changes in disc length and displacement distance would be greater in ADDWoR than ADDWR, so was the deformity extension of disc
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