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Is Double Anchorage Superior to Single Anchorage in Patients With Temporomandibular Joint Symptomatic Disc
Tiebiao Wang1, Shuailin Peng2, Shuo Cui2
1PhD Student, Resident, School of Stomatology, Jiangxi Medical College, Nanchang University Jiangxi Province Key Laboratory of Oral Biomedicine, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, Jiangxi, China.
Background:
For symptomatic anterior disc displacement without reduction, articular disc repositioning aims to enhance clinical function. It's unclear if double anchorage (DA) is superior to single anchorage (SA) in this procedure.
Purpose:
The purpose of this study was to compare the therapeutic effects of DA or SA in subjects with temporomandibular joint symptomatic disc displacement (SDD).
Study Design, Setting, Sample:
The authors implemented a single-center retrospective cohort study. Subjects with Wilkes III-V stage SDD who underwent open temporomandibular joint disc plication at the Affiliated Stomatological Hospital of Nanchang University were identified via electronic medical records. The exclusion criteria of this study were as follows: (1) severe systemic diseases; (2) mental disorders; and (3) inability to complete follow-up.
Predictor Variable:
The predictor variable was the disc anchorage technique, which was grouped into DA and SA.
Main Outcome Variable(S):
The primary outcome variable was the therapeutic effect, including pain (assessed using the visual analog scale), maximal interincisal opening (MIO), and the craniomandibular index (CMI). The secondary outcomes were quality of life and postoperative disc position. Among these, visual analog scale, MIO, CMI, and quality of life were recorded at T0 (preoperation), T1 (1 month postoperation), T2 (3 months postoperation), and T3 (6 months postoperation); postoperative disc position was recorded between T2 and T3.
Covariates:
The covariates included demographics (age, sex), perioperative variables (Wilkes stage,laterality (unilateral or bilateral), and presence or absence of perforation).
Analyses:
Repeated measures analysis of variance (ANOVA) examined various effects. For primary outcomes, independent samples t-tests were used for between-group comparisons and paired t-tests for within-group comparisons, with significance set at P < .05.
Results:
The sample included 137 subjects (DA: 70, 51%; SA: 67, 49%), with an overall mean age of 41.24 (±18.02) years and 19.0% female/81.0% male. For the DA and SA groups, mean pain reduction was from 6.30 (±1.34) to 0.73 (±0.92) and 6.00 (±1.60) to 1.33 (±1.16), mean MIO increase from 20.86 (±4.77) to 36.33 (±4.11) and 21.64 (±4.94) to 34.82 (±4.49), and mean CMI reduction from 0.51 (±0.10) to 0.13 (±0.11) and 0.47 (±0.14) to 0.18 (±0.12), respectively (all P < .05); all pairwise comparisons were significant (P < .05).
Conclusion:
The results suggest that DA was associated with superior therapeutic effects compared to SA and is a suitable alternative in SDD surgery.
