Spallaccia Fabrizio, De Tomaso Silvia, Cirignaco Giulio, Angelo David Faustino, Vaira Luigi Angelo, Vellone Valentino
Department of Maxillofacial Surgery, "S. Maria" Hospital, 05100 Terni, Italy.
Department of Maxillofacial Surgery, University of Siena, Policlinico Santa Maria alle Scotte, Viale Mario Bracci, 53100 Siena, Italy.
J Clin Med. 2025 Apr 8;14(8):2560. doi: 10.3390/jcm14082560.
: Anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) often leads to persistent pain and reduced quality of life (QoL). Conservative treatments frequently fail to provide adequate symptom relief. : To assess the short-term (≥6 months) effectiveness of functional arthroplasty in reducing pain and improving QoL in patients with ADDwoR unresponsive to conservative therapies. : A retrospective cohort study was conducted on 105 patients (median age 38 years, 80% female) treated at Santa Maria Hospital from January 2018 to December 2021. All patients had unilateral painful ADDwoR confirmed via MRI and underwent functional arthroplasty. Primary outcomes included pain reduction (VAS) and QoL improvements (QoL-TMJ questionnaire). Covariates such as age, gender, and baseline mood disturbances were analyzed for associations with surgical outcomes. Statistical analyses included the Wilcoxon rank test, Friedman's ANOVA, and Spearman's rank correlation. : Postoperative VAS scores significantly decreased (8.0 pre-op vs. 2.0 post-op, < 0.001). QoL-TMJ scores improved significantly in pain ( < 0.001), activity ( < 0.05), mood ( < 0.001), and anxiety ( < 0.01), but no significant changes were observed in chewing and speaking functions. Improvements in QoL correlated strongly with pain reduction. Gender and age did not influence the outcomes, though females reported higher baseline mood disturbances. : Functional arthroplasty effectively reduces pain and improves QoL in patients with ADDwoR, regardless of age or gender. However, limited improvement in chewing and speaking abilities highlights the need for targeted interventions. Future studies should assess the long-term outcomes to confirm the sustained benefits of this procedure.
颞下颌关节不可复性盘前移位（ADDwoR）常导致持续性疼痛和生活质量（QoL）下降。保守治疗往往无法充分缓解症状。
评估功能性关节成形术对保守治疗无反应的ADDwoR患者减轻疼痛和改善生活质量的短期（≥6个月）效果。
对2018年1月至2021年12月在圣玛丽亚医院接受治疗的105例患者（中位年龄38岁，80%为女性）进行了一项回顾性队列研究。所有患者均经MRI证实为单侧疼痛性ADDwoR，并接受了功能性关节成形术。主要结局包括疼痛减轻（视觉模拟量表[VAS]）和生活质量改善（颞下颌关节生活质量问卷[QoL-TMJ]）。分析年龄、性别和基线情绪障碍等协变量与手术结局的相关性。统计分析包括Wilcoxon秩和检验、Friedman方差分析和Spearman秩相关分析。
术后VAS评分显著降低（术前8.0 vs.术后2.0，<0.001）。QoL-TMJ评分在疼痛（<0.001）、活动（<0.05）、情绪（<0.001）和焦虑（<0.01）方面有显著改善，但咀嚼和说话功能未观察到显著变化。生活质量的改善与疼痛减轻密切相关。性别和年龄不影响结局，尽管女性报告的基线情绪障碍较高。
功能性关节成形术可有效减轻ADDwoR患者的疼痛并改善生活质量，无论年龄或性别如何。然而，咀嚼和说话能力改善有限凸显了针对性干预的必要性。未来的研究应评估长期结局，以证实该手术的持续益处。
