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Acute trauma induced disc displacement without reduction and its sequelae
DongMei He1, XiuJuan Yang1, FeiYu Wang1
1Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Key Laboratory of Stomatology, Shanghai, 200011, China.
Scientific Reports
|September 2, 2016
Summary
Acute traumatic temporomandibular joint disc displacement (ATDD) can lead to severe joint damage. Surgical interventions like disc repositioning and total joint replacement (TJR) significantly improve mouth opening and alleviate pain in ATDD patients.
Area of Science:
- Oral and Maxillofacial Surgery
- Orthodontics
- Radiology
Background:
- Acute traumatic temporomandibular joint disc displacement (ATDD) and its consequences are often unfamiliar to surgeons.
- This study focuses on sequelae in patients with persistent disc displacement after failed conservative management.
Purpose of the Study:
- To investigate the long-term sequelae of ATDD in patients who did not undergo disc reduction.
- To evaluate the effectiveness of surgical interventions for improving mouth opening and pain relief in these cases.
Main Methods:
- A cohort of 26 patients (34 joints) with ATDD, treated conservatively for at least 3 months, was retrospectively analyzed.
- Maximal incisor opening (MIO) was measured, and MRI was used to assess condylar bone degeneration.
- Surgical treatments, including total joint replacement (TJR) and disc repositioning, were performed on selected patients.
Main Results:
- After conservative treatment, average MIO was 25.7 mm, with MRI revealing significant condylar bone destruction (41.2%) and severe resorption (35.3%).
- Surgical intervention in 15 patients (23 joints) led to a significant improvement in MIO from 19.8 mm to 33.9 mm (p < 0.00001).
- Disc repositioning and TJR were effective in improving MIO.
Conclusions:
- ATDD can result in severe temporomandibular joint osteoarthritis and ankylosis.
- Surgical treatment, including disc repositioning and TJR, offers significant functional improvement for patients with ATDD sequelae.
- Early surgical consideration may be warranted for persistent ATDD cases unresponsive to conservative therapy.
