Arthroscopic discopexy versus natural course of temporomandibular joint anterior disc displacement: a longitudinal study of clinical and radiological outcomes |
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| Institution: | 1. Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. College of Stomatology, Shanghai Jiao Tong University, School of Medicine, Shanghai, China;3. Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China;4. Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Türkiye;2. Department of Anaesthesiology and Reanimation, Faculty of Medicine, Istanbul Medipol University, Istanbul, Türkiye;1. Neurosciences Study Group, Federal University of Sergipe, São Cristóvão, Brazil;2. Nursing Department, Federal University of Sergipe, Aracaju, Brazil;3. Department of Morphology, Federal University of Sergipe, São Cristóvão, Brazil;1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand;2. Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden;1. Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;2. Department of Oral and Maxillofacial Surgery, Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel;1. Department of Oral Maxillofacial–Head Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China;2. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China;3. Department of Otolaryngology–Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA;4. Department of CT Clinical Research, CT Business Unit, Canon Medical Systems (China) Co., Ltd, Beijing, China |
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| 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. |
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| Keywords: | Temporomandibular joint Temporomandibular joint disc Joint dislocation Arthroscopy Longitudinal studies |
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