Effect of occlusal stabilisation splint with or without arthroscopic disc repositioning on condylar bone remodelling in adolescent patients

Int J Oral Maxillofac Surg. 2024 Feb;53(2):156-164. doi: 10.1016/j.ijom.2023.06.005. Epub 2023 Jun 24.

Abstract

The aim of this study was to investigate the treatment effects of a stabilisation splint (SS) with and without arthroscopic disc repositioning (ADR) on condylar bone remodelling in adolescent patients with anterior disc displacement without reduction (ADDwoR). Cone beam computed tomography and magnetic resonance imaging were used to analyse condylar bone remodelling, condyle position, and disc position. Twenty-two temporomandibular joints of 14 patients who underwent ADR (age range 12-20 years; mean follow-up 12.5 ± 7.8 months) and 21 temporomandibular joints of 14 patients who did not undergo ADR (age range 13-20 years; mean follow-up 11.1 ± 5.1 months) were included. The change in bone volume (P < 0.001), rate of bone volume change (P < 0.001), and change in condyle height (P = 0.031) were significantly greater in patients with ADR than in those without ADR. The changes in posterior joint space (P = 0.013), superior joint space (P = 0.020), and ratio of condyle sagittal position (P = 0.013) were significantly greater in patients with ADR than in those without ADR. All discs in patients who underwent ADR and one disc in those who did not undergo ADR were backward repositioned. In conclusion, in adolescent patients with ADDwoR, ADR with SS therapy achieved better condyle and disc position than SS therapy alone, and also induced bone generation.

Keywords: Arthroscopy; Bone remodelling; Mandibular condyle; Occlusal splints; Temporomandibular joint disc.

MeSH terms

  • Adolescent
  • Adult
  • Bone Remodeling
  • Child
  • Humans
  • Joint Dislocations* / surgery
  • Magnetic Resonance Imaging / methods
  • Mandibular Condyle / diagnostic imaging
  • Mandibular Condyle / pathology
  • Occlusal Splints
  • Splints
  • Temporomandibular Joint / pathology
  • Temporomandibular Joint Disc / surgery
  • Temporomandibular Joint Disorders* / diagnostic imaging
  • Temporomandibular Joint Disorders* / pathology
  • Temporomandibular Joint Disorders* / therapy
  • Young Adult