"The effect of disc repositioning on regenerative condylar bone remodelling in juvenile patients with temporomandibular joint osteoarthritis: a retrospective cohort study".

OBJECTIVES

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).

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.

CLINICAL RELEVANVE

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.