症状性円板変位に対する関節鏡視下円板固定術の成功に関連する要因

Daniel Jerez¹, Camila Ávila-Oliver², German Laissle³

¹Academic Director at Clinical Bupa Santiago, Head of the Unit of Oral and Maxillofacial Surgery at Clinical Bupa Santiago, Oral and Maxillofacial Surgeon Hospital Dr. Luis Calvo Mackenna, Santiago, Chile.

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

|January 13, 2026

要旨

Background:

Symptomatic disc displacement (SDD) is a common temporomandibular joint disorder, with arthroscopic discopexy being one of the treatment options that offers the advantages of a minimally invasive approach.

Purpose:

The purpose was to evaluate factors associated with favorable outcomes after mattress-loop technique (Yang's technique) for arthroscopic discopexy in subjects with SDD.

Study Design, Setting, And Sample:

This prospective cohort study was conducted at a tertiary care center (Clínica Bupa Santiago). Patients presenting between 2022 and 2024 with SDD who required arthroscopic discopexy were enrolled. Exclusion criteria included missing preoperative data or unavailable preoperative magnetic resonance imaging (MRI).

Predictor Variable:

The predictor variable was a set of heterogenous variables categorized as demographic, perioperative, or imaging.

Main Outcome Variables:

The main outcome variable was therapeutic effect measured using (1) visual analog scale to assess pain and (2) maximum incisal opening (MIO). The secondary outcome was radiographic, measured using disc stability assessed on 6-month MRI based on disc position. All variables were measured at baseline and at 6 months postoperatively.

Covariates:

Not applicable.

Analyses:

Data were analyzed using descriptive and inferential statistics, a statistical significance was set at P value < .05. Mixed-effects regression models with a random intercept for patient to account for correlation between joints within the same individual were performed for changes in pain, MIO, and disc position stability.

Results:

A total of 218 joints from 141 subjects were included. At 6 months, pain decreased from a mean of 5.53 ± 2.42 to 0.81 ± 1.60 (Δ = 4.72, P < .05) and MIO increased from 31.29 ± 9.13 mm to 38.52 ± 4.61 mm (Δ = 7.23 mm, P < .05). MRI follow-up showed disc stability in 120 joints (89.5%). Female sex, younger age, and the presence of clicking were significantly associated with greater improvements in pain and MIO. After adjusting for males experienced significantly less pain reduction (β = -1.56, P = .03), and younger subjects (β = -0.17 mm/year, P = .002) had better pain relief and improved MIO respespectively.

Conclusion (And Relevance):

The results suggest that mattress-loop technique was associated with reducing pain, increasing MIO, and preserving short-term disc stability at 6 months. Younger age was the strongest predictor of favorable outcomes, supporting early intervention in this population.

キーワード:

関節鏡視下円板固定術症候性円板変位顎関節マットレスループ法治療成績

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