Department of Oral & Maxillofacial Surgery, College of Stomatology, North China University of Science and Technology, Tangshan City, Hebei Province, PR China.
Department of Oral & Maxillofacial Surgery, Cangzhou Central Hospital, Cangzhou City, Hebei Province, PR China.
Clin Oral Investig. 2024 Aug 15;28(9):487. doi: 10.1007/s00784-024-05864-3.
To assess the influence of unilateral open disc repositioning surgery (ODRS) of the temporomandibular joint (TMJ) on the internal derangement (ID) of the contralateral joint.
Patients with bilateral ID of TMJ who underwent unilateral ODRS were enrolled and followed-up for one year. They were divided into two groups based on the contralateral disease: the anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR). Postoperative evaluation included clinical and MRI evaluation. Indices measured were unilateral intermaxillary distance (UID), visual analogue scale (VAS), disc length (DL), condylar height (CH), and disc-condyle angle (DCA). Paired t tests were used to compare the clinical and MRI indices between different time points.
Ninety-six patients were enrolled, including 47 in the ADDWR group and 49 in the ADDWoR group. One-year post-surgery, ODRS led to significant increases in MMO, DL, and CH, and decrease in VAS and DCA on the operated side (P < 0.05). In ADDWR group, UID, DL, and CH increased significantly, and VAS decreased (P < 0.05), with no significant change in DCA (P > 0.05). In ADDWoR group, clinical and MRI variables worsened slightly, except for UID, which remained unchanged (P > 0.05).
ODRS is a promising method for correcting TMJ ID and may improve condition of ADDWR and decrease progress of ADDWoR at the contralateral joint. Preoperative bilateral TMJ evaluation is essential for better outcomes.
ODRS can effectively treat TMJ ID and produce adaptive changes in the contralateral ID, for which continuous monitoring of the contralateral joint is essential.
评估单侧关节盘复位术（ODRS）对颞下颌关节（TMJ）对侧关节内部紊乱（ID）的影响。
纳入双侧 TMJ ID 患者行单侧 ODRS，并随访 1 年。根据对侧疾病将其分为两组：可复性关节盘前移位伴复位（ADDWR）和不可复性关节盘前移位不伴复位（ADDWoR）。术后评估包括临床和 MRI 评估。测量的指标包括单侧颌间距离（UID）、视觉模拟评分（VAS）、关节盘长度（DL）、髁突高度（CH）和关节盘-髁突角（DCA）。采用配对 t 检验比较不同时间点的临床和 MRI 指标。
共纳入 96 例患者，其中 ADDWR 组 47 例，ADDWoR 组 49 例。术后 1 年，ODRS 使患侧 MMO、DL 和 CH 显著增加，VAS 和 DCA 显著降低（P<0.05）。在 ADDWR 组，UID、DL 和 CH 显著增加，VAS 降低（P<0.05），DCA 无明显变化（P>0.05）。在 ADDWoR 组，除 UID 保持不变外（P>0.05），临床和 MRI 变量略有恶化。
ODRS 是一种有前途的 TMJ ID 矫正方法，可能改善对侧 ADDWR 状况并减缓 ADDWoR 进展。术前双侧 TMJ 评估对于获得更好的疗效至关重要。
ODRS 可有效治疗 TMJ ID，并使对侧 ID 产生适应性变化，因此必须持续监测对侧关节。
