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Abstract Objective To study the changes of temporomandibular joints and craniocervical posture in adult patients with bilateral anterior disc displacement, and to explore their correlation, which may provide some clinical value for clinical diagnosis and treatment planning. Methods Ninety-eight adult patients were divided into 3 groups: 29 patients in bilateral disc normal position group (BN), 33 patients in bilateral Anterior Disc Displacement With Reduction group (ADDWR) and 36 patients in bilateral Anterior Disc Displacement Without Reduction group (ADDWoR). Dolphin and Uceph software were used to measure 14 items of temporomandibular joint and 11 items of craniocervical posture for comparison and correlation analysis between groups. Results There were significant differences in bilateral joint space between three groups. Compared with the BN, the anteroposterior diameter of the condyle was significantly reduced, the condyle was significantly displaced posteriorly and superiorly in the ADDWR and ADDWoR, but the joint fossa width and joint fossa depth did not change significantly. Cervical curvature and inclination were greater in patients with anterior disc displacement than BN, indicating that the craniocervical posture of adult patients with anterior disc displacement was extended and protrusive. Conclusion Anterior disc displacement of the temporomandibular joint can displace the condyle upwards and posteriorly and reduce the anteroposterior diameter of condyle, and then make the condyle closer to the wall of articular fossa to induce joint symptoms. Additionally, craniocervical postural position is significantly affected, which may be related to compensate for the effects of airway space.

This study aims to investigate the morphological characteristics of the temporomandibular joint (TMJ) in the patients with anterior disc displacement with reduction (ADDwR) and the alterations after occlusal splint treatment. Thirty ADDwR patients and ten asymptomatic subjects were recruited. Thirteen parameters were adopted, along with automatic computation and presentation of the joint space to characterize the TMJ morphologies. Statistical results showed that morphological discrepancies between the patients and the asymptomatic subjects were ubiquitous. The adjustment of condyle position through occlusal splint treatment can result in joint spaces widening and has positive effects on mitigating the conditions of ADDwR. [ABSTRACT FROM AUTHOR]

Objective·To introduce and evaluate a Chinese embedded temporomandibular joint (TMJ) anchoring nail in a clinical trial. Methods·From June 2018 to November 2018, 43 patients with anterior disc displacement without reduction were selected from the Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. TMJ disc reposition and fixation was performed to them all. For unilateral patients, a Chinese embedded nail was used to reduce the articular disc. For bilateral patients, a Chinese embedded anchoring nail was used on the right side and a traditional anchoring nail was used on the left side. Clinical and magnetic resonance imaging (MRI) examination were performed before surgery, 1 month after surgery, 6 months after surgery and 1 year after surgery. Clinical evaluation indexes included maximum interincisal opening (MIO) and TMJ pain score. The disc position, disc length and condylar height were measured by MRI, by using three-circle method. Repetitive measnre analysis of variance was used for statistical analysis of preoperative and postoperative MIO, visual analog scale (VAS) score for TMJ pain, disc length and condyle height. Results·Thirty-one patients with fifty-three joints finished all follow-up periods. The success rates of Chinese embedded anchoring nail and traditional anchoring nail were 90.3% and 90.9%, respectively. One year after surgery, the patients' jaw motion improved significantly. The MIO increased from (34.65±8.63) mm before surgery to (42.84±7.46) mm 1 year after surgery (P=0.000). The pain was significantly alleviated, and the VAS score for TMJ pain decreased from (2.94±1.13) before surgery to (0.39±0.55) 1 year after surgery (P=0.000). Postoperative MRI examination result showed increased disc length. The condyle height did not change significantly 6 months after surgery (P>0.05), but it increased by an average of 1.54 mm 1 year after surgery (P=0.002). None of the 31 joints with the Chinese embeded anchorage nail had foreign body sensation, while of the 22 joints with the traditional anchorage nail, 7 patients could feel the protrusion in front of the tragus, and 2 of them had obvious foreign body sensation. Conclusions·Improved Chinese embedded TMJ anchoring nail has similar success rate and less foreign body sensation than traditional anchoring nail. TMJ disc repositioning and fixation is beneficial to improve joint function and relieve pain. New bone can be detected 1 year after surgery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between upper airway dimension and craniocervical posture in adult patients with bilateral anterior disc displacement and to provide some references for clinical diagnosis and plan formulation in orthodontics., Methods: Based on RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorder), 98 Patients were divided into three groups by two experienced TMJ (Temporomandibular Joint) specialists: bilateral disc normal position group (BN), bilateral anterior disc displacement with reduction group (ADDWR) and bilateral anterior disc displacement without reduction group (ADDWoR). Inter-group comparison and correlation analysis were performed after 11 craniocervical posture and 15 upper airway dimension measurements finished with Dolphin and Uceph software in Two or Three-dimensional., Results: Anterior disc displacement often accompanied with extension of craniocervical posture, as ADDWR and ADDWoR groups have significantly higher cervical curvature and inclination than BN group (P < 0.05). Simultaneously anterior disc displacement often associated with constrained upper airway dimension for the total and each segment upper airway volume were significantly smaller in ADDWR and ADDWoR than BN group (P < 0.05). Correlation analysis revealed that C0-C1 (the distance from the base of the occipital bone (C0) to the posterior arch of the atlas (C1)) is significantly related to the total and each segment upper airway volume reduction (P < 0.05)., Conclusion: There exists markedly close correlation between anterior disc displacement and craniocervical posture forward extension, which may be physiologically adaptive cervical extension to keep oropharyngeal airway unobstructed as upper airway dimension constrained by anterior disc displacement., Clinical Relevance: These findings allow us to infer the potential consequences if the treatment of anterior disc displacement would result in an improvement of intervertebral relationships and upper airway constraint., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Ultrasonography has been applied as an alternative method in the assessment of temporomandibular joint (TMJ) pathology including anterior disc displacement (ADD). However, a concrete screening or diagnostic method which is feasible in clinical practice has not yet been established. The study aimed to establish a quantitative ultrasonographic method and determine its diagnostic efficacy for ADD of the TMJ., Methods: A total of 75 joints were allocated to either the normal disc position (NDP) group or the ADD group using magnetic resonance imaging (MRI) as the reference standard. Longitudinal scans of the lateral articular compartment were obtained by a 14-MHz L-shaped linear array transducer. The width of the lateral joint space (LJS), the upper lateral joint space (ULJS), and the lower lateral joint space (LLJS), as well as the position of the lateral articular disc edge (ADE), were investigated by stepwise logistic regression analysis to identify significant indicators of ADD and to build a diagnostic model. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were computed at the optimal cut-off value., Results: MRI detected 25 joints in the NDP group and 50 joints in the ADD group. Correlation analysis indicated that all 4 variables were associated with ADD. With the best performance of the area under the receiver operating characteristic (ROC) curve (AUC) of 0.939, LJS and ULJS were identified as predictors of ADD and subsequently adopted to build a diagnostic model by stepwise logistic regression. The optimal cut-off value of the 2-variable regression model for diagnosing ADD was 0.800, with a sensitivity of 82%, specificity of 96%, PPV of 97.6%, NPV of 72.7%, and an accuracy of 86.7%., Conclusions: The quantitative ultrasonographic diagnostic method showed promising diagnostic efficacy. It has the potential to be used for ADD screening in future clinical practice., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-401/coif). The authors have no conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)