Predicting anterior repositioning splint efficacy in disc displacement with reduction using MRI-based texture and...

Area of Science:

• Temporomandibular joint (TMJ) disorders
• Biomedical imaging
• Orthodontics

Background:

• Disc displacement with reduction (DDWR) is a common TMJ disorder.
• Anterior repositioning splint (ARS) therapy is a conservative treatment approach.
• Predictive factors for ARS efficacy require further investigation.

Purpose of the Study:

• To analyze factors influencing ARS therapy efficacy in DDWR patients.
• To evaluate the prognostic value of MRI-based texture analysis (TA) of retrodiscal tissue (RDT).

Main Methods:

• Retrospective study of 82 DDWR patients (140 joints) treated with ARS.
• MRI evaluation at four time points (pre-treatment, post-insertion, post-treatment, follow-up).
• Quantification of disc morphology/position and TA of RDT using GLCM parameters, including Angular Second Moment (ASM).

Main Results:

• 60% of joints achieved excellent outcomes with ARS, 34% improved, 6% poor.
• Higher mandibular protrusive distance correlated with excellent outcomes (P=0.032).
• Significant reductions in disc displacement and disc-condyle angle observed post-ARS (P<0.01).
• ASM showed a strong positive association with excellent (OR=9.545) and improved (OR=8.272) outcomes.

Conclusions:

• ARS is an effective conservative treatment for DDWR, improving disc-condyle relationships.
• High disc recapture rates correlate with excellent outcomes.
• ASM identified via MRI texture analysis may serve as a predictive biomarker for ARS treatment success.