Prognostic Indicators of Yang’s Arthroscopic Technique for Management of Temporomandibular Joint Anterior Disc Displacement: Part 1- Clinical Predictors.

Abstract

In order to optimize the patient selection for specific treatment modality and to achieve favorable treatment outcomes, prognostic indicators impacting the results are important to analyze. This longitudinal retrospective study aimed to analyze various prognostic factors impacting the surgical outcomes following Yang’s arthroscopic discopexy for management of temporomandibular joint anterior disc displacement using success criteria based on pain, maximal interincisal opening, diet, and quality of life. Furthermore, a quantitative MRI assessment of disc position and condylar height was performed pre- and postoperatively. Multinomial analysis was used to evaluate various prognostic variables including gender, age, duration of illness, Wilkes staging, parafunctional habits, and splint/orthodontic therapy. A total of 169 patients (234 joints) were included. The outcome was categorized as excellent (n = 67/39.6%), good (n = 72/42.6%), improved (n = 22/13.01%) or poor (n = 8/4.73%) with a success rate of 95.26%. Patients aged from 11–15 years old were significantly more likely to be in the good outcome group (odds ratio (OR), 0.20; P < 0.05). Also, patients with shorter duration of illness (OR, 0.29; P < 0.05) and with Wilkes stage III (OR, 0.11; P < 0.05) were more likely to be in the improved outcome group. Better outcomes can be achieved at younger patients with shorter disease history and earlier Wilkes staging.