Abstract:

Objective To discuss the efficacy of temporomandibular joint disc anchoring （TMJDA） in the treatment of anterior disc displacement without reduction （ADDWoR） from clinical and imaging perspectives， in order to improve the clinicians’ understanding of this surgical approach. Methods Twenty-one ADDWoR patients who underwent TMJDA were retrospectively collected， involving a total of 25 temporomandibular joints （TMJs）. The maximum mouth opening， visual analogue scale （VAS） score for pain， and Helkimo index were measured preoperatively， 1 month postoperatively， and 6 months postoperatively in all the patients. Postoperative complications and satisfaction questionnaires were designed for the patients to self-evaluate the efficacy， and their magnetic resonance imaging （MRI） findings were assessed. Results Compared with preoperative period， the maximum mouth opening at 1 month and 6 months postoperatively was significantly increased （P<0.05）； compared with 1 month postoperatively， the maximum mouth opening at 6 months postoperatively was significantly increased （P<0.05）. Compared with preoperative period， the VAS scores at 1 month and 6 months postoperatively were significantly decreased （P<0.05）； compared with 1 month postoperatively， the VAS score at 6 months postoperatively was significantly decreased （P<0.05）. Compared with preoperative period， the percentages of the patients with Di 0 and DiⅠ scores were significantly increased （P<0.05）， while those with DiⅡ and DiⅢ scores were significantly decreased （P<0.05）， indicating significant improvement in TMJ function after surgery. Among the 21 ADDWoR patients， 14 （66.67%） were satisfied and 7 （33.33%） were basically satisfied. Compared with preoperative period， the disc length was significantly increased postoperatively （P<0.01）， while no significant difference was observed in condylar height （P>0.05）； all displaced discs were repositioned postoperatively； among the 25 joints， 23 （92.00%） were evaluated as “excellent” and 2 （8.00%） were evaluated as “good”. No patients experienced postoperative facial nerve injury， local alopecia， surgical area depression， salivary fistula， or Frey syndrome； 3 patients （3 joints） developed numbness in the preauricular area within 24 hours postoperatively， which resolved by the 6-month follow-up. Conclusion TMJDA for the treatment of ADDWoR can stably reposition the disc， significantly improve mouth opening and pain levels， with a low incidence of postoperative complications.

Key words: Temporomandibular joint disc anchoring, Anterior disc displacement without reduction, Magnetic resonance imaging, Temporomandibular joint disorders, Condyle