Hu Ying Kai, Yang Chi, Xie Qian Yang
Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, Shanghai Key Laboratory of Stomatology, People's Republic of China.
Sci Rep. 2016 Sep 27;6:34253. doi: 10.1038/srep34253.
Treatment procedures for anterior disc displacement (ADD) of temporomandibular joint (TMJ) are far from reaching a consensus. The aim of the study was to evaluate disc status changes of anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR) comparatively, to get a better understanding of the disease progress without intervention. 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) examination. The joints were assessed quantitatively for disc length and displacement distance at initial and follow-up visits. Disc morphology, which was classified in 5 types, was 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. Moreover, analysis of covariance was applied to analyze influential factors for changes in disc length and displacement distance. According to our results, discs tended to become shorter, move further forward and distort more seriously in ADDWoR group than in ADDWR group after follow-up. Moreover, discs were prone to become shorter and more anteriorly displaced in teenagers, type I and III morphologies, advanced Wilkes stages, or those with joint effusion. Follow-up period seemed to be not critical.
颞下颌关节（TMJ）前盘移位（ADD）的治疗方法远未达成共识。本研究的目的是比较性评估可复性前盘移位（ADDWR）和不可复性前盘移位（ADDWoR）的盘状结构变化，以便在不进行干预的情况下更好地了解疾病进展。这项纵向回顾性研究纳入了165例患者的217个关节，根据磁共振成像（MRI）检查将其分为ADDWR组和ADDWoR组。在初次就诊和随访时对关节的盘状结构长度和移位距离进行定量评估。还对分为5种类型的盘状结构形态进行了评估。采用配对t检验和Wilcoxon符号秩检验评估组内差异，采用独立t检验评估组间差异。此外，应用协方差分析来分析盘状结构长度和移位距离变化的影响因素。根据我们的结果，随访后ADDWoR组的盘状结构比ADDWR组更倾向于变短、向前移位更远且变形更严重。此外，在青少年、I型和III型形态、Wilkes分期较高或有关节积液的患者中，盘状结构更容易变短和向前移位。随访时间似乎并不关键。
