Huang Linjian, Li Miaoran, Xu Xin, Xie Zhijian
Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang province, PR China; Department of Oral and Maxillofacial Surgery, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou 310005, Zhejiang Province, PR China.
Department of Orthodontics, Hangzhou Dental Hospital, West Branch, Hangzhou 310063, Zhejiang province, PR China.
J Stomatol Oral Maxillofac Surg. 2025 Oct;126(5S):102418. doi: 10.1016/j.jormas.2025.102418. Epub 2025 May 29.
This study aimed to investigate surgery-related changes in condylar height, disc length, disc displacement, and tissue thickness of the temporomandibular joint (TMJ) after skeletal anchorage surgery to obtain a better understanding of surgical outcomes and to provide useful information for treatment protocols.
This retrospective cohort study included 172 joints in 86 patients with unilateral anterior disc displacement without reduction (AddwoR), which were divided into an untreated group and an operation group. All patients had 2 magnetic resonance imaging records for measurement at the initial visit and follow-up visit respectively. The t-test was used to assess intra- and inter-group differences.
In the untreated group, the changes in condylar height, disc length, and disc displacement on the AddwoR side were -0.98 mm, -0.11 mm and 0.74 mm, respectively. In the operation group, the changes in the condylar height, disc length, disc displacement and tissue thickness on the AddwoR side after anchorage surgery were 0.84 mm, 0.21 mm, -6.63 mm and -0.87 mm, respectively. A statistically significant difference was observed between the two groups.
The present study suggests that the condylar height and disc length of AddwoR without treatment tended to decrease with time. Additionally, TMJ skeletal anchorage surgery effectively reversed the decreases in condylar height and disc length. However, the findings suggest that TMJ anchorage surgery results in a decrease in tissue thickness. Preoperative tissue quality should be considered when planning surgical interventions to minimize the risk of tissue thinning.
本研究旨在调查骨骼锚固手术后颞下颌关节（TMJ）髁突高度、盘长度、盘移位及组织厚度的手术相关变化，以更好地了解手术效果，并为治疗方案提供有用信息。
这项回顾性队列研究纳入了86例单侧不可复性盘前移位（AddwoR）患者的172个关节，分为未治疗组和手术组。所有患者在初诊和随访时分别有2次磁共振成像记录用于测量。采用t检验评估组内和组间差异。
在未治疗组中，AddwoR侧的髁突高度、盘长度和盘移位变化分别为-0.98mm、-0.11mm和0.74mm。在手术组中，锚固手术后AddwoR侧的髁突高度、盘长度、盘移位和组织厚度变化分别为0.84mm、0.21mm、-6.63mm和-0.87mm。两组间观察到统计学上的显著差异。
本研究表明，未经治疗的AddwoR的髁突高度和盘长度倾向于随时间降低。此外，TMJ骨骼锚固手术有效地逆转了髁突高度和盘长度的降低。然而，研究结果表明TMJ锚固手术会导致组织厚度降低。在规划手术干预时应考虑术前组织质量，以尽量减少组织变薄的风险。
