Liu Wei, Wu Zuping, Hu Yiming, Chen Yilin, Wang Chenyu, Wang Ying, Shi Jiejun
Key Laboratory of Oral Biomedical Research of Zhejiang Province & Zhejiang Provincial Clinical Research Center for Oral Diseases, Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Oral Rehabil. 2025 Sep 26. doi: 10.1111/joor.70066.
Temporomandibular disorders (TMD) primarily affect adolescents and young adults, with potentially distinct risks and clinical outcomes. However, most studies focus on a single age group, and the lack of comparative research hinders clinical decisions regarding optimal intervention timing and treatment strategies.
This study aims to investigate temporomandibular joint bony structural changes in adolescents and adults with anterior disc displacement with reduction (ADDwR) or without reduction (ADDwoR) using Cone-Beam Computed Tomography (CBCT).
A total of 99 TMD patients (54 adolescents, 45 adults) with no history of TMD treatment were included, all of whom had undergone two CBCT scans with an average follow-up of 11.30 ± 1.68 months. Condylar morphological and positional indicators were measured, and condylar bone changes were evaluated using a scoring system.
Significant changes were observed in adolescents, with the ADDwR group showing increased condylar volume and surface area but a reduced morphological index, accompanied by bone changes that showed minimal progression during the observation period, while the ADDwoR group showed reductions in most morphological parameters and progressively worsening bone changes. Dynamic shifts in condylar position were also noted in adolescents, with the ADDwR group showing an increase in posterior positioning, while the ADDwoR group shifted towards the central position. In adults, both ADDwR and ADDwoR groups demonstrated condylar morphology and position that remained largely unchanged over the observation period, with a tendency towards relieved bone destruction indicating potential for bone repair.
These findings underscore distinct progression patterns across age groups and ADD subtypes, supporting the need for stratified TMD treatment.
颞下颌关节紊乱病（TMD）主要影响青少年和年轻人，其风险和临床结果可能存在明显差异。然而，大多数研究仅关注单一年龄组，缺乏比较研究阻碍了关于最佳干预时机和治疗策略的临床决策。
本研究旨在使用锥形束计算机断层扫描（CBCT）调查青少年和成人可复性盘前移位（ADDwR）或不可复性盘前移位（ADDwoR）患者的颞下颌关节骨结构变化。
共纳入99例无TMD治疗史的TMD患者（54例青少年，45例成人），所有患者均接受了两次CBCT扫描，平均随访时间为11.30±1.68个月。测量髁突形态和位置指标，并使用评分系统评估髁突骨变化。
青少年患者观察到显著变化，ADDwR组髁突体积和表面积增加，但形态指数降低，同时观察期内骨变化进展最小，而ADDwoR组大多数形态学参数降低，骨变化逐渐恶化。青少年患者髁突位置也有动态变化，ADDwR组后位增加，而ADDwoR组向中央位置移动。在成人中，ADDwR组和ADDwoR组在观察期内髁突形态和位置基本保持不变，骨破坏有减轻趋势，表明有骨修复潜力。
这些发现强调了不同年龄组和ADD亚型的不同进展模式，支持分层治疗TMD的必要性。
