Changes in the Temporomandibular Joint Space After Functional Treatment of Disk Displacement With Reduction

Abstract

This study aimed to evaluate the changes of temporomandibularjoint (TMJ) space in the treatment of disk displacement with reduction (DDWR) for class II cases. Forty-two adolescent patients with unilateral DDWR, who were successfully treated by functional appliance, were selected in this study. Magnetic resonance imaging scans were used before treatment (T1), at the start of treatment (T2), and after functional treatment (T3). Compared with the normal joint, the change of joint space index was calculated. The anterior, posterior, and superior joint spaces were analyzed on the largest sagittal plane among T1, T2, and T3. Student's t-test was used for statistical analysis. The mean treatment period was 10 months (6-16 mo). Functional appliance was effective in eliminating pain and clicking. During the phase of T1, the value of the joint space index of DDWR was significantly higher than that of the control (P < 0.05). There was a significant decrease in the anterior space and an increase in the postsuperior space at T2 (P < 0.01), and then the contrary changes occurred at T3. However, there was a significant increase in the postsuperior space and no significant decrease in the anterior space when T1 and T3 were compared. This study indicates that the TMJ space is well distributed after disk repositioning with functional treatment of DDWR. It is also suggested that the adaptive remodeling in TMJ occurs via functional treatment.

Non-invasive joint decompression: An important factor in the regeneration of the bone marrow and disc recapture in temporomandibular arthropathies

“…It has been shown that the key treatment for the pains that involve the various joints of the body, including TMJ, is to reduce the overload and allow joint movement as soon as possible ( 1 - 3 , 9 , 10 ). Dystrophic calcification / medullar sclerosis seen on magnetic resonance imaging, when present in TMJ indicates an advanced stage of arthropathy ( 11 , 12 ), but sometimes representing little pain or signs typical of temporomandibular disorders ( 13 ), probably due to increased joint space and decompression caused by the alteration of the anatomical form of the condyle, fossa and joint eminence.Regarding the displacement of the TMJ joint disc, it has been suggested that the disc repositioning is conditioned by the increase of the joint space with mandibular orthopedic modification called joint decompression ( 2 , 3 ), and the increase of space is the main responsible for joint disc maintenance. Thus, the long-term stability of the disc tissues is conditioned to the increase of the joint space, consequently the rehydration and increase of volume of the tissues, as well as the need to occupy the increased space between the jaws connected to the resting caused by the deprogramming, that’s why the IO / interocclusal orthotic is used.…”

Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis

“…Nonetheless, in TMJs with disc displacements, condyles are usually posteriorly positioned in their joint fossae . TMJ spaces are typically well distributed with functional and ARS therapy . While condyle concentricity was not explicitly assessed, analysis of X‐Y coordinates showed that condyles with ADDwR were 0·97 ± 0·51 mm behind point G in the maximum intercuspal position pre‐treatment when compared to 0·21 ± 1·59 mm for normal joints (Table ).…”

Assessment of Occlusal Appliance in Repositioning of the Temporomandibular Joint Anterior Disc Displacement With Reduction: A 3 to 36 Months Follow-Up

“…Z. Ma и со-авт. установили, что ношение функциональных систем у больных с вывихом диска с репозицией помогает сформировать правильную форму су-ставного пространства ВНЧС и способствует его адаптивному ремоделированию [22]. Это проис-ходит благодаря тому, что при открывании рта или выдвижении нижней челюсти вперед диск у пациентов с передним вывихом диска с репо-зицией возвращается в нормальное положение.…”