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Changes in disc status in the reducing and nonreducing anterior disc displacement of temporomandibular joint: a longitudinal retrospective study

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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.

No MeSH data available.


MRI scans of a 16-year-old female ADDWR patient with the interval of 21 months, showing almost unchanged disc status.(A) First visit, (B) Follow-up visit.
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f4: MRI scans of a 16-year-old female ADDWR patient with the interval of 21 months, showing almost unchanged disc status.(A) First visit, (B) Follow-up visit.

Mentions: When the analysis of covariance was applied for ∆L, age, disc morphology, Wilkes stage and joint effusion were correlated (Table 7), whereas gender was categorized as nonsignificant. The younger the patient was, the more the disc shortened (P ≤ 0.001). In terms of disc morphology, unlike the results of univariate analysis, compared with type I, the danger of disc shortening decreased significantly in type II, IV and V (P = 0.025, P < 0.001, and P = 0.021, respectively), while no significant difference was found between type I and III (P = 0.135), demonstrating U-shaped or V-shaped folded configuration accelerated disc shortening. Besides, the disc shortened more in ADDWoR (stage III–V) (Fig. 3) than in ADDWR (stage I and II) (Fig. 4). Furthermore, joint effusion seemed to raise the risk of disc shortening significantly, too (P = 0.002).


Changes in disc status in the reducing and nonreducing anterior disc displacement of temporomandibular joint: a longitudinal retrospective study
MRI scans of a 16-year-old female ADDWR patient with the interval of 21 months, showing almost unchanged disc status.(A) First visit, (B) Follow-up visit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037465&req=5

f4: MRI scans of a 16-year-old female ADDWR patient with the interval of 21 months, showing almost unchanged disc status.(A) First visit, (B) Follow-up visit.
Mentions: When the analysis of covariance was applied for ∆L, age, disc morphology, Wilkes stage and joint effusion were correlated (Table 7), whereas gender was categorized as nonsignificant. The younger the patient was, the more the disc shortened (P ≤ 0.001). In terms of disc morphology, unlike the results of univariate analysis, compared with type I, the danger of disc shortening decreased significantly in type II, IV and V (P = 0.025, P < 0.001, and P = 0.021, respectively), while no significant difference was found between type I and III (P = 0.135), demonstrating U-shaped or V-shaped folded configuration accelerated disc shortening. Besides, the disc shortened more in ADDWoR (stage III–V) (Fig. 3) than in ADDWR (stage I and II) (Fig. 4). Furthermore, joint effusion seemed to raise the risk of disc shortening significantly, too (P = 0.002).

View Article: PubMed Central - PubMed

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.

No MeSH data available.