Liu Xin, Long Xing
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.
Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, Hubei, 430079, China.
Clin Oral Investig. 2025 May 31;29(6):322. doi: 10.1007/s00784-025-06408-z.
This study aimed to analyze the positional characteristics of the temporomandibular joint (TMJ) disc in patients with anterior disc displacement without reduction (ADDWoR) using magnetic resonance imaging (MRI).
2,827 MRI images from 2,168 ADDWoR patients were collected and categorized into two groups: without limited opening (WoLO) group and with limited opening (WLO) group. The position of TMJ disc and their distribution characteristics in these two groups were analyzed from the oblique sagittal planes of MRI.
The disc positions were classified into 11 types based on oblique sagittal MRI images during maximum mouth opening. Anterior displacement was the most common in both groups, with 39.65% in WoLO and 41.96% in WLO. Anteroinferior displacement and anteroinferior displacement in the lateral part were also prevalent, particularly in the WLO group. While the MRI imaging features of superior displacement did not appear in the WLO group, due to mouth opening limitation. The effect of masticatory muscles and condylar excursion during mouth opening play a crucial role in the displacement of TMJ disc.
ADDWoR patients of WoLO group primarily manifest disc anterior displacement, anteroinferior in the lateral part, and anteroinferior displacement. ADDWoR patients of WLO group are more likely to exhibit disc anterior displacement and anteroinferior displacement, without the manifestation of superior displacement.
The position of the anterior displaced disc can guide treatment strategies, conservative treatment alleviating restricted mouth opening for anteroinferior displacement patients, or controlling excessive mouth opening to relieve ligamentous laxity for anterosuperior displacement patients.
本研究旨在利用磁共振成像（MRI）分析不可复性盘前移位（ADDWoR）患者颞下颌关节（TMJ）盘的位置特征。
收集2168例ADDWoR患者的2827张MRI图像，并分为两组：无开口受限（WoLO）组和有开口受限（WLO）组。从MRI的斜矢状面分析这两组中TMJ盘的位置及其分布特征。
根据最大张口时的斜矢状面MRI图像，盘位置分为11种类型。两组中最常见的都是前移位，WoLO组为39.65%，WLO组为41.96%。前下移位和外侧部分的前下移位也很普遍，尤其是在WLO组。由于开口受限，WLO组未出现上移位的MRI成像特征。张口时咀嚼肌和髁突运动轨迹对TMJ盘移位起关键作用。
WoLO组的ADDWoR患者主要表现为盘前移位、外侧部分前下移位和前下移位。WLO组的ADDWoR患者更易出现盘前移位和前下移位，无盘上移位表现。
前移盘的位置可指导治疗策略，对于前下移位患者，保守治疗可缓解开口受限，对于前上移位患者，可控制过度开口以减轻韧带松弛。
