Dong Haoran, Lei Jie, Chen Shuo, Jie Bimeng, Zhang Yi, Fu Kaiyuan, He Yang
Department of Oral and Maxillofacial Surgery, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China.
Centre for TMD and Orofacial Pain, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China.
Clin Oral Investig. 2025 Jan 31;29(2):104. doi: 10.1007/s00784-025-06184-w.
A retrospective cohort study was conducted to compare the treatment outcomes between arthroscopic disc repositioning and suturing surgery, and conservative treatment (without disc repositioning) in juvenile patients with anterior disc displacement without reduction (ADDwoR) and temporomandibular joint osteoarthritis (TMJOA).
Patients treated with arthroscopic surgery (surgery group) between March 2022 and March 2023, and those treated with conservative therapy (control group) between July 2014 and August 2022 were included. The patients were assessed clinically and with CBCT before and after the treatments (minimum interval of 6 months).
A total of 38 patients were included in the study, with 19 patients in each of the groups. The postoperative mouth opening and joint pain improved significantly in both groups (P < 0.05), and there was no significant difference between them (P > 0.05). Besides clinical symptom relief, both treatments could promote regenerative condylar remodeling. More importantly, the increase in condylar head height and volume in the surgery group was significantly larger than those in the control group (P < 0.001). The occurrence of regenerative condylar remodeling in the surgery group (96.6%) was significantly higher than that in the control group (68.4%, P < 0.001). However, the occurrence of condylar regeneration was exclusively observed in the surgery group.
The arthroscopic surgery has comparable effect to the conservative treatment on improving clinical symptoms, while it has better regenerative condylar remodeling results compared to the conservative treatment.
This study demonstrated that arthroscopic surgery was superior to conservative treatment in promoting regenerative condylar remodeling, which is of significance to guide the treatment decision of juvenile patients with ADDwoR and TMJOA.
进行一项回顾性队列研究，比较关节镜下盘复位缝合手术与保守治疗（不进行盘复位）对青少年不可复性盘前移位（ADDwoR）和颞下颌关节骨关节炎（TMJOA）患者的治疗效果。
纳入2022年3月至2023年3月接受关节镜手术治疗的患者（手术组），以及2014年7月至2022年8月接受保守治疗的患者（对照组）。在治疗前后（最短间隔6个月）对患者进行临床评估和CBCT检查。
本研究共纳入38例患者，每组19例。两组术后张口度和关节疼痛均有显著改善（P<0.05），且两组间无显著差异（P>0.05）。除临床症状缓解外，两种治疗均可促进髁突再生性重塑。更重要的是，手术组髁突头部高度和体积的增加显著大于对照组（P<0.001）。手术组再生性髁突重塑的发生率（96.6%）显著高于对照组（68.4%，P<0.001）。然而，仅在手术组观察到髁突再生的发生。
关节镜手术在改善临床症状方面与保守治疗效果相当，但在髁突再生性重塑方面优于保守治疗。
本研究表明，关节镜手术在促进髁突再生性重塑方面优于保守治疗，这对指导青少年ADDwoR和TMJOA患者的治疗决策具有重要意义。
