Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (7): 54-61.doi: 10.6040/j.issn.1671-7554.0.2025.0626

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Quantitative analysis of disc-condyle movement following arthroscopic disc repositioning operation for ADDWoR

JIN Chenxi1,2, SHEN Wei1,2, LI Na2, SUN Jianfeng2, YANG Chi3, GUO Jing1,2   

  1. 1. School of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China;
    2. Department of Orthodontics, Ningbo Stomatology Hospital Affiliated to Hangzhou Medical College, Ningbo 315016, Zhejiang, China;
    3. Department of Oral Surgery, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine;
    College of Stomatology, Shanghai Jiao Tong University;
    National Center for Stomatology;
    National Clinical Research Center for Oral Diseases;
    Shanghai Key Laboratory of Stomatology, Shanghai 200011, China
  • Published:2025-07-08

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Abstract: Objective To assess the location of the disc and the movement characteristics of the disc-condyle following arthroscopic disc repositioning operation(ADRO)for the anterior disc displacement without reduction(ADDWoR). Methods A total of 108 patients were enrolled in Ningbo Stomatology Hospital during Jan. 2021 and Jun. 2024, who were with symptoms/signs of temporomandibular disorders(TMD), or protrusive mouth, mandibular retrusion or deviation as the main complaint. Magnetic resonance imaging(MRI)served as the gold standard for determining disc-condyle relationships. Through a four-step screening process, 31 patients(62 joints)without anterior disc displacement were classified as the normal group. Due to disc-condyle heterogeneity between ADDWoR and anterior disc displacement with reduction(ADDWR), 48 patients(83 ADDWoR joints)underwent an ADRO and comprised the surgical group. Assessments were performed preoperatively(group A0)and at 1(group A1M), 3(group A3M), and 6(group A6M)months postoperatively, measuring visual analogue scale(VAS)pain scores, disc-condyle angle, disc-condyle mobility, and coronal mesial-lateral displacement. Results (1)The VAS pain score in group A0 was significantly higher than that in the normal group(P<0.001). The differences in VAS pain scores between the groups A0, A1M, A3M, and A6M were all statistically significant(P<0.05). (2) In the coronal view, disc displacement was rare in the normal group(lateral shift rate: 9.68%). The discs were invisible in the group A0. At A6M, the discs were visualized in 20/83 joints, with lateral shift in 6/20 joints. In the sagittal view, significant differences in the disc-condyle angle existed between the normal group and both the groups A0/A6M during closed-mouth and open-mouth positions. Significant differences in open-close movement were also found between the normal group and the groups A0/A6M(P<0.001). (3) In the coronal view, the number of visualized discs and laterally shifted discs increased progressively across the postoperative groups. Sagittally, the disc-condyle angle gradually increased over time, though the rate of increase decreased. Statistically significant differences were found in the median disc-condyle angle between group A0 and groups A1M, A3M, and A6M(P<0.05). The disc-condyle mobility progressively increased in all postoperative groups (P<0.05). (4) Spearman correlation analysis: closed-mouth disc mobility demonstrated a significant negative correlation with the surgical disc position(rs=-0.486, P<0.001; rs=-0.550, P<0.001). Conclusion ADRO significantly improved disc position(particularly sagittal reduction)and functional mobility in ADDWoR, concomitant with postoperative pain relief. A surgical disc position between 0° to -30° represents a favorable range for overcorrection to maximize postoperative disc-condyle mobility.

Key words: Arthroscopic disc repositioning operation, Anterior disc displacement without reduction, Disc-condyle angle, Disc-condyle mobility, Magnetic resonance imaging

CLC Number: 

  • R783.5
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