A Prognostic Nomogram for Postoperative Bone Remodeling in Patients with ADDWoR

Abstract

This study aimed to establish an effective prognostic nomogram for predicting the probability of postoperative bone remodeling of patients with anterior disc displacement without reduction (ADDWoR). The nomogram was based on a retrospective study on patients underwent surgical approaches for ADDWoR at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University from January, 2007 to January, 2017. A multivariate logistic regression analysis was used to develop variables suitable for probability estimation model. The predictive accuracy and discriminative ability were determined by ROC (AUC-index) and calibration curve. Results were validated using bootstrap resampling with all statistical tests two-sided. 1110 patients were included in the analysis. The probability of postoperative bone remodeling in ADDWoR was 0.51. Six independent prognostic factors including age of onset, nocturnal bruxism, disc morphology, BMD, Wilkes’ classification, and postoperative splint therapy were integrated to construct the nomogram. The probability estimation model showed good discrimination in both internal and external validation with AUC-index of 0.84. The calibration curves for probability of postoperative bone remodeling showed optimal agreement with actual observation. In conclusion, a nomogram was established to provide individual prediction of postoperative bone remodeling for patients with ADDWoR treated by arthroscopy surgery.

The magnetic resonance imaging evaluation of condylar new bone remodeling after Yang’s TMJ arthroscopic surgery

“…Some scholars 21 , 22 have studied the bone remodeling after TMJ arthroscopic disc reposition. Liu XH et al 22 conducted a retrospective study on the formation of new bone in patients after arthroscopy through the study method of prognosis nomogram. The results showed that the rate of new bone formation after arthroscopy was about 50% considering the sex, age, Wilkes stage, bad oral habits (such as bruxism).…”

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

“…Liu et al 31 implemented a prognostic nomogram to predict the prognostic variables most associated with higher chances of successful disc repositioning, re ected by postoperative new bone formation and condylar remodeling as an important index of treatment outcome which can reverse the effects caused by ADD. They concluded that age of onset, nocturnal bruxism, disc morphology, bone marrow density, Wilkes stages, and postoperative splint therapy were signi cantly associated with bone remodeling after arthroscopic surgery.…”

Proteome Analysis of Temporomandibular Joint with Disc Displacement

“…Condylar resorption was based on 2 TMJ-MRI scans with a 6-mo interval. It presented as a rough and discontinuous cortical bone outline in the sagittal view with decreased condylar height as compared with baseline (Shen et al 2014;Liu et al 2018). At 6 mo after surgery, patients again underwent TMJ-MRI; according to which, new bone formation was defined as the condyle head presenting with a double cortical phenomenon and increased condylar height as compared with baseline (Liu et al 2018;Dong et al 2021) Protein Extraction and Trypsin Digestion SF was lysed by urea (8 M), loaded with protein supernatants into 10-kD filtration devices (Microcon; Millipore), and filtered.…”

“…It presented as a rough and discontinuous cortical bone outline in the sagittal view with decreased condylar height as compared with baseline (Shen et al 2014;Liu et al 2018). At 6 mo after surgery, patients again underwent TMJ-MRI; according to which, new bone formation was defined as the condyle head presenting with a double cortical phenomenon and increased condylar height as compared with baseline (Liu et al 2018;Dong et al 2021) Protein Extraction and Trypsin Digestion SF was lysed by urea (8 M), loaded with protein supernatants into 10-kD filtration devices (Microcon; Millipore), and filtered. Then, the samples were digested with trypsin.…”

“…Once severe resorption appears, complicated surgery is required, including arthroplasty and joint replacement, which might be physically and economically stressful for patients. Meanwhile, early intervention such as disc reposition is reported to promote condylar regeneration in some cases (Liu et al 2018; Dong et al 2021). This postoperative new bone, which is deemed a positive index of the treatment, can improve or even reverse facial deformity (Liu et al 2020).…”