Morphological analysis of the temporomandibular joint in patients with anterior disc displacement

Sun, Tinghui; Shao, Bingmei; Chong, D.Y.R.; Liu, Zhan

doi:10.1080/10255842.2023.2188990

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…In the literature, there is a dilemma about the most suitable type of splint therapy among the different types of splint therapy [ 24 ]. The anterior repositioning splint (ARS), hard stabilization splint, soft stabilization splint, mini-anterior splint, and prefabricated splint approaches reportedly show varying degrees of clinical efficacy in the treatment of TMDs compared to no treatment [ 22 , 25 ]. Previous studies in patients with internal derangements have revealed that splints helped in achieving a statistically significant reduction in TMJ pain, TMJ noises and disability, with corresponding improvements in jaw function after the disc was repositioned [ 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical and MRI-Based Assessment of Patients with Temporomandibular Disorders Treated by Controlled Mandibular Repositioning

Singh,

Landry,

Schmid-Schwap

et al. 2024

Diagnostics

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Background: Occlusal splints and anterior repositioning splints (ARSs) are widely accepted treatments for temporomandibular disorders (TMDs). However, there is uncertainty with regard to the most suitable amount of mandibular repositioning. The aim of this study is to evaluate the clinical and functional effects of the therapeutic position (ThP) established based on the Controlled Mandibular Repositioning (CMR) method. Methods: In this clinical trial, 20 subjects with 37 joints with disc displacement with reduction were recruited. The initial standard functional diagnostic protocol, MRI, and digital condylography were performed, and ThP was calculated with the CMR method. After a 6-month follow-up, the standard diagnostic protocol was repeated. The change in disc position was evaluated by means of MRI after 6 months of CMR therapy. Results: The MRI findings in the parasagittal plane demonstrated that out of the 37 joints presenting disc displacement, 36 discs were successfully repositioned; thus, the condyle–disc–fossa relationship was re-established. Therefore, the success rate of this pilot study was 97.3%. The mean position of the displaced discs was at 10:30 o’clock of the TMJ joint and at 12:00 o’clock after CMR therapy. Conclusions: The ThP determined using the CMR approach reduced all of the anteriorly displaced discs (except one). The CMR method allowed to define an optimum ThP of the mandible thus supporting patients’ effective adaptation to treatment position.

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Section: Introductionmentioning

confidence: 99%

Clinical and MRI-Based Assessment of Patients with Temporomandibular Disorders Treated by Controlled Mandibular Repositioning

Singh,

Landry,

Schmid-Schwap

et al. 2024

Diagnostics

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Features of the Treatment of Hypermobility of the Articular Heads and Dislocations of the Lower Jaw on the Background of Fractures of the Condygal Processes of the Mandible, as a Prevention of Alloplastic Replacements of the Tempomandibular Joint

Toropov,

Avetikov,

Skikevych

et al. 2024

Ukr. Dent. Alm.

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Acute, chronic, and recurrent dislocations are currently defined as conditions in which the mandibular process becomes dislocated from its joints and requires manipulation by another person to return to its normal position. Such conditions are usually preceded by either iatrogenic factors, including fractures of the mandibular branch, or joint instability and hypermobility of its heads. This pathology requires a personalized treatment algorithm: in each case, the clinical and radiological signs of this pathology should be clearly taken into account and the method of conservative or surgical treatment should be determined. Each of them has its advantages and disadvantages, and their combined use is also possible, which is the key to preventing more significant complications that can lead to allostatic replacements, joint components, or joint replacement as a whole. The purpose of the study is to conduct a comparative analysis of the data of clinical examinations, conservative and surgical treatment, complications and postoperative results, taking into account the prevalence of chronic dislocations of the mandible against the background of condylar fractures. Clinical cases of chronic dislocations of the mandible lasting from one to three months after osteosynthesis were analyzed by the authors. Attempts at manual reduction did not bring a positive result, so it was decided to treat the patients conservatively, using bite blocks made of self-hardening plastic and the use of elastic methods of fixation of the mandible, which gave a positive result already in the third week of treatment. Also, these patients were observed in the clinic for 6 months without visualization of complications of both mechanical and inflammatory nature. The analysis of clinical case data allows us to state that the goal of treatment should be to return the condyles to their original physiological position, and conservative methods should be in the first place when creating an algorithm. Early manual reduction of the joint heads is the best method of treatment, if it is possible to carry it out in a timely manner. As the duration of the dislocation increases, the joint cavity is filled with connective tissue, cartilaginous changes occur, adhesions between the articular surfaces are formed, the masticatory muscles shorten with possible fibrosis of the temporalis muscle. We have confirmed the fact that one of the best conservative treatments is the use of an elastic chin-parietal bandage, which acts as a fulcrum to move the heads back under the anterior slope of the articular tubercle, with the simultaneous use of arches and posterior occlusal rollers. If this treatment does not bring a positive result, we use intraoral splints with a fulcrum in the area of the second molar in combination with extraoral traction to move the heads in the posterior direction with simultaneous stretching of the capsule of the temporomandibular joint and its intracapsular ligaments. It should be noted that in each case, all the features of the pathogenesis of this disease should be taken into account and a personalized treatment algorithm should be developed, consisting of conservative methods, and, if ineffective, surgical treatment.

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Morphological analysis of the temporomandibular joint in patients with anterior disc displacement

Cited by 2 publications

References 28 publications

Clinical and MRI-Based Assessment of Patients with Temporomandibular Disorders Treated by Controlled Mandibular Repositioning

Clinical and MRI-Based Assessment of Patients with Temporomandibular Disorders Treated by Controlled Mandibular Repositioning

Features of the Treatment of Hypermobility of the Articular Heads and Dislocations of the Lower Jaw on the Background of Fractures of the Condygal Processes of the Mandible, as a Prevention of Alloplastic Replacements of the Tempomandibular Joint

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