Kong Mi-Sun, Huh Kyung-Hoe, Kho Hong-Seop
Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
Clin Oral Investig. 2025 Jan 30;29(2):98. doi: 10.1007/s00784-025-06177-9.
This study was aimed to investigate the efficacy of comprehensive conservative treatments in patients with temporomandibular joint (TMJ) retrodiscal layer rupture and/or disc perforation.
This was a retrospective study of thirty-one consecutive patients with findings of TMJ retrodiscal layer rupture and/or disc perforation using magnetic resonance imaging. Comprehensive stomatognathic system assessments were performed. Comprehensive treatment modalities were applied to each patient and treatment outcomes were analyzed. The changes in patient-reported symptoms and comfortable mouth opening (CMO) and maximum mouth opening (MMO) distances were analyzed between the baseline and after treatment.
Twenty-eight females and three males were included in this study. Four patients (12.9%) reported a history of facial injury and another four (12.9%) reported having rheumatoid arthritis. Unilateral chewing was the most frequently reported parafunctional habit, followed by clenching. The mean treatment duration was 24.3 ± 11.1 months. Most of the patients received more than one type of treatment. Both CMO and MMO distances increased significantly (P < 0.001) after treatment. Approximately three-quarters of patients reported partial improvement in symptoms, and one-fourth reported complete improvement.
Comprehensive conservative treatments were effective and should be applied first in patients with TMJ retrodiscal layer rupture and/or disc perforation.
Conservative treatments are recommended for patients with severe damage to the TMJ structures, such as retrodiscal layer rupture and/or disc perforation, before applying surgical approach.
本研究旨在探讨综合保守治疗对颞下颌关节（TMJ）盘后组织破裂和/或盘穿孔患者的疗效。
这是一项对31例经磁共振成像检查发现TMJ盘后组织破裂和/或盘穿孔的连续患者进行的回顾性研究。进行了全面的口颌系统评估。对每位患者应用综合治疗方法并分析治疗结果。分析了患者报告的症状以及舒适张口度（CMO）和最大张口度（MMO）距离在基线和治疗后的变化。
本研究纳入了28名女性和3名男性。4名患者（12.9%）报告有面部损伤史，另外4名患者（12.9%）报告患有类风湿关节炎。单侧咀嚼是最常报告的副功能习惯，其次是紧咬牙。平均治疗时间为24.3±11.1个月。大多数患者接受了不止一种类型的治疗。治疗后CMO和MMO距离均显著增加（P<0.001）。约四分之三的患者报告症状部分改善，四分之一的患者报告完全改善。
综合保守治疗有效，应首先应用于TMJ盘后组织破裂和/或盘穿孔患者。
对于TMJ结构严重受损的患者，如盘后组织破裂和/或盘穿孔，在采用手术方法之前，建议进行保守治疗。
