Degenerative temporomandibular joint changes associated with recent-onset disc displacement without reduction in adolescents and young adults

Condylar repair and regeneration in adolescents/young adults with early‐stage degenerative temporomandibular joint disease: A randomised controlled study

“…Interestingly, for the 14 joints in the splint group that required physical TMJ closed‐lock reduction (improved disc‐condyle relationship), 12/14 (85.7%) joints showed remarkable repair and new bone formation. The transition from normal joint to DDw/oR and TMJ DJD had been deliberated . Prompt intervention of DDw/oR in adolescents/young adults is advocated to increase the likelihood of bone regeneration and restoration of condylar form and structure.…”

“…Approval was obtained from the Biomedical Institutional Review Board of Peking University (PKUSSIRB‐201414054) and Chinese Clinical Trial Registry (Bone defect repair in early osteoarthrosis of temporomandibular joint by joint distraction therapy: A randomised controlled trial/ChiCTR‐TRC‐14005172) prior to starting this prospective, blinded and randomised clinical trial. Subject inclusion criteria for study eligibility were as follows: (a) adolescents and young adults aged 12‐30 years old; (b) diagnosis of TMJ DJD with/without arthralgia based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); (c) presence of early‐stage TMJ condylar DJD (ie, condylar surface erosion and/or destruction) based on CBCT imaging; and (d) documented informed consent from participants or their guardians (if they were under 18 years old). DC/TMD assessment was performed by an experienced and trained assessor, and the age range of 12‐30 years was selected as the prevalence of TMD under 12 years old is low, and condylar remodelling is active during this period .…”

“…CBCT data were reconstructed, and multiple images of axial, coronal and sagittal planes of the joints at 0.48‐mm slice intervals were acquired. CBCT images of condyles with early TMJ DJD exhibited primarily loss of continuity of the articular cortex and/or surface erosion/destruction . Advanced osteoarthritic changes, such as deviation in form, sclerosis, osteophyte formation and cyst‐like lesions, were not included in this study.…”

“…CBCT images of condyles with early TMJ DJD exhibited primarily loss of continuity of the articular cortex and/or surface erosion/destruction . Advanced osteoarthritic changes, such as deviation in form, sclerosis, osteophyte formation and cyst‐like lesions, were not included in this study. Four successive 0.48‐mm mid‐coronal slices of the pre‐ and post‐treatment condylar images were compared, and osseous changes after treatment were qualitatively classified into four categories: (a) progressed: further condylar bone destruction or condyle deformation (Figure ); (b) unchanged (Figure ); (c) repaired (remodelled without new bone formation, ie, previous loss of articular cortex continuity or surface erosion/destruction became complete and smooth) (Figure ); and (d) regenerated (remodelled with new bone formation, ie, “double contour” images were observed over previous bony defect) (Figure ).…”

“…The prevalence of TMJ DJD is estimated to range from 8% to 35% in the general population based on radiographic assessment . Prevalence was found to be even higher (approximately 60%) in individuals with disc displacement without reduction (DDw/oR) …”