MRI evaluation of disc status changes of anterior displacement with reduction and without reduction

doi:10.19438/j.cjoms.2017.06.006

Abstract

Abstract: PURPOSE: The aim of the study was to evaluate disc status changes of anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR),in order to get a better understanding of the disease progress without intervention. METHODS: This longitudinal retrospective study included 217 joints in 165 patients, which were divided into ADDWR group and ADDWoR group based on magnetic resonance imaging (MRI). The joints were assessed quantitatively for disc length and displacement distance at initial and follow-up visits. Disc morphology, which was classified into 5 types, as well as Wilkes stages were also evaluated. Paired t test and Wilcoxon signed rank test were used to assess intra-group differences and independent t test for inter-group differences using SPSS 17.0 software package. RESULTS: There were 86 joints in ADDWR group and 131 joints in ADDwoR group. The follow-up interval was 9.38 months in ADDWR group, compared to 8.54 months in ADDWoR group. Discs tended to become shorter, move further forward and distort more seriously in ADDWoR group than in ADDWR group during follow-up period. Type I disc morphology dominated in ADDwR group both at first and follow-up visits, demonstrating great value of disc repositioning. However, major disc morphology changed from type II to type IV in ADDWoR group, indicating decrease of the value of disc repositioning. CONCLUSIONS: Discs tended to become shorter, move further forward and distort more seriously, especially in ADDWoR group, which reminds TMJ surgeons to perform disc repositioning surgery as soon for ADDWoR patients with risk factors, instead of nonsurgical surgery for 6 months that may lead to serious deterioration in disc status.

Key words: Temporomandibular joint, Anterior disc displacement, MRI

CLC Number:

R739.8

HU Ying-kai, YANG Chi, CAI Xie-yi, XIE Qian-yang. MRI evaluation of disc status changes of anterior displacement with reduction and without reduction[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(6): 508-514.

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