Department of Oral & Maxillofacial Surgery, Shenzhen Stomatology Hospital Affiliated to Shenzhen University, Shenzhen, GuangDong Province, China.
J Oral Rehabil. 2024 Dec;51(12):2675-2682. doi: 10.1111/joor.13866. Epub 2024 Sep 27.
To analyse the correlation between temporomandibular joint (TMJ) disc perforation and degenerative joint changes (DJC) on cone-beam computed tomography (CBCT) and related factors.
A total of 238 female patients with anterior disc displacement without reduction (ADDwoR), accounting for 348 affected joints, requiring TMJ disc open anchorage surgery were included in the study conducted from June 2021 to August 2022. Following TMJ disc open anchorage surgery, patients were divided into two groups: disc perforation (DP) and disc non-perforation (DNP). CBCT was utilised to assess different grades of condyle and articular eminence degenerative changes, and comparisons were made between the two groups regarding DJC and clinically relevant factors.
In comparison with the DNP group, the DP group exhibited statistically significant differences in mid- and late-stage condyle bone degenerative changes and bone alterations of the articular eminence (odds ratio [OR] = 7.822; 95% CI [4.438-13.785]; p < 0.001 and OR = 5.575; 95% CI [3.128-9.936]; p < 0.001). Additionally, persistent joint sounds (OR = 1.932; 95% CI [1.011-3.691]; p = 0.046) and longer disease duration (OR = 4.901; 95% CI [2.395-10.028]; p < 0.001) demonstrated statistically significant differences. However, no significant differences were observed between the two groups in terms of age, joint pain and limited mouth opening.
Bone degeneration changes in TMJ CBCT images are a high possible risk factor for DP. With an escalation in the degree of condyle degeneration, the risk of DP may increased correspondingly. Persistent joint sounds and extended duration of the disease were also confirmed to be noteworthy clinical risks of DP.
分析颞下颌关节（TMJ）盘穿孔与退行性关节变化（DIC）在锥形束 CT（CBCT）上的相关性及其相关因素。
本研究共纳入 2021 年 6 月至 2022 年 8 月期间因前 TMJ 盘移位伴不可复性（ADDwoR）、需要 TMJ 盘开放锚定术的 238 例女性患者，共涉及 348 个受累关节。TMJ 盘开放锚定术后，患者分为盘穿孔（DP）组和盘无穿孔（DNP）组。使用 CBCT 评估不同等级的髁状突和关节结节退行性变化，并比较两组 DJC 和临床相关因素的差异。
与 DNP 组相比，DP 组中髁状突中晚期骨退行性改变和关节结节骨改变的差异有统计学意义（比值比 [OR] = 7.822；95%置信区间 [4.438-13.785]；p<0.001 和 OR = 5.575；95%置信区间 [3.128-9.936]；p<0.001）。此外，持续的关节弹响（OR = 1.932；95%置信区间 [1.011-3.691]；p = 0.046）和较长的病程（OR = 4.901；95%置信区间 [2.395-10.028]；p<0.001）也有统计学差异。然而，两组在年龄、关节疼痛和张口受限方面无统计学差异。
TMJ CBCT 图像上的骨退变改变是 DP 的一个高危因素。随着髁状突退变程度的加重，DP 的风险可能相应增加。持续的关节弹响和延长的病程也被证实是 DP 的重要临床风险因素。
