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Is Arthroscopic Disc Repositioning Associated With Condylar Height Change in Adolescents and Young Adults With
Ling Zhou1, Jie Lei2, Haoran Dong3
1MD Student, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Background:
Anterior disc displacement without reduction (ADDwoR) may be associated with degenerative condylar changes that compromise condylar and mandibular development. It remains unclear whether arthroscopic disc repositioning promotes condylar remodeling.
Purpose:
To measure and identify factors associated with condylar height changes (ΔH) after arthroscopic surgery among patients with ADDwoR.
Study Design, Setting, Sample:
This retrospective cohort study included female patients aged 10 to 20 years with ADDwoR at Peking University Hospital of Stomatology between January 2022 and August 2024. Inclusion criteria were joint pain and/or restricted mouth opening for ≥3 months and follow up ≥6 months. Exclusion criteria were other temporomandibular joint/craniofacial disorders, prior temporomandibular joint surgery, or orthodontic treatment.
Primary Predictor Variable:
The primary predictor variable was treatment group, coded as operative or nonoperative.
Primary Outcome Variable:
The primary outcome variable was ΔH, measured on cone-beam computed tomography images at baseline and the last follow up. Positive ΔH indicated increased condylar height.
Covariates:
Covariates included age, overjet, follow-up duration, disc length, disc position relative to the condyle, and condylar bone destruction grade.
Analyses:
Uni-, bi-, and multivariable analyses were executed to assess the association between treatment group, covariates, and ΔH. Statistical significance was set at P value < .05.
Results:
The study included 83 female subjects (mean age 15.34 ± 2.24 years), with 60 (72.3%) in the operative group and 23 (27.7%) in the nonoperative group. The mean ΔH was 0.80 ± 0.90 mm and -0.16 ± 1.13 mm in the operative and nonoperative groups, respectively (P < .001). After adjusting for age, overjet, follow-up duration, disc length, disc position relative to the condyle, and condylar bone destruction grade, ΔH was statistically significantly associated with treatment, favoring operative therapy (b = 0.893, P < .001).
Conclusions And Relevance:
Positive ΔH was associated with arthroscopic disc repositioning after adjustment. These findings may help guide counseling and follow-up planning.
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