Disc Repositioning

Gonçalves, João Roberto; Cassano, Daniel Serra; Rezende, Luciano; Wolford, Larry M.

doi:10.1016/j.coms.2014.09.007

Cited by 47 publications

(13 citation statements)

References 65 publications

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“…After treatment, disc displacement diagnosis by MRI or RDC/TMD was not changed, except for one patient, which was expected since TMJ discs cannot be replaced by minimal invasive technique [ 36 ]. Disc position in coronal view was altered in 5 joints after treatment, and this may be due to better lubrication and recovery of mandibular dynamics obtained by VS. Joint sound is the clinical sign that RDC/TMD utilizes for disc displacement diagnosis, but disc position can only be determined by MRI analysis [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series

Fonseca

Januzzi

Ferreira

et al. 2018

Pain Research and Management

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Viscosupplementation is a minimally invasive technique that replaces synovial fluid by intra-articular injection of hyaluronic acid (HA). Although effective in some joints, there is not conclusive evidence regarding temporomandibular disorders. This case series described the efficacy of a viscosupplementation protocol in intra-articular temporomandibular disorders. Ten patients with a diagnosis of disc displacement and/or osteoarthritis by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to four monthly injections of low or medium molecular weight HA. Pain, mandibular function, image analysis by tomography and magnetic resonance, and quality of life were assessed at baseline and follow-ups (1 and 6 months). Pain, jaw range-of-motion, mandibular function, and quality of life improved at follow-up evaluations. Osteoarthritis changes decreased, and 20% of patients improved mandibular head excursion after treatment. Resolution of effusion and improvement in disc morphology were observed for most patients. This viscosupplementation protocol reduced pain and symptoms associated with internal derangement of temporomandibular joint, improved quality of life, and showed benefits from both low and medium molecular weight HA in alternate cycles.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series

Fonseca

Januzzi

Ferreira

et al. 2018

Pain Research and Management

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“…Therefore, for most patients, post-operative disc positions were evaluated by digital palpation and the path of mouth opening. Nonetheless, this method was effective for diagnosing disc displacement [14].…”

Section: Discussionmentioning

confidence: 90%

“…However, several oral and maxillofacial surgeons have reported that the effectiveness of TMJ disc repositioning is low [14]. In this context, some surgeons preferred non-invasive techniques like arthroscopy rather than invasive TMJ repositioning surgery to resolve TMJ ID [15].…”

Section: Introductionmentioning

confidence: 99%

“…The surgeons attributed this outcome to the posterior part of the disc remaining open after the junction with the retrodiscal tissue of the TMJ was excised. As a result of this preparatory procedure, severe scarring can develop in the dead space [14]. To overcome this technical hurdle, we modified the conventional technique by utilizing MITEK mini anchors.…”

Section: Introductionmentioning

confidence: 99%

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Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

Lee

Hong

2020

Maxillofac Plast Reconstr Surg

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Background The purpose of this study is to introduce our modified disc plication technique using MITEK mini anchors and to evaluate the clinical outcome for patients with internal derangement (ID) of the temporomandibular joint (TMJ). Patients and methods We evaluated 65 joints in 46 patients, comprised 32 women and 14 men, who first visited the Asan Medical Center from December 2012 to December 2016. The age of the patients ranged from 14 to 79 years, with a mean age of 36.6 years. The patients presented with joint problems including pain, joint noise, and mouth opening limitation (MOL). Patients who met our inclusion criteria underwent unilateral or bilateral disc repositioning surgery with our minimally invasive disc plication technique using MITEK mini anchors and No. 2-0 Ethibond® braided polyester sutures. The variables taken into account in this study were the range of maximum mouth opening (MMO), painful symptoms (evaluated with the visual analog scale, VAS), and the type of noise (click, popping, crepitus) in the TMJ. Results Preoperative examination revealed painful symptoms in 50.7% (n = 35) of the operated joints (n = 69) and the presence of clicks in 56.5% (n = 39). Postoperative examination revealed that 4.3% (n = 3) of the operated joints had painful symptoms with lower intensity than that in the preoperative condition. Additionally, 17.4% (n = 12) had residual noise in the TMJ, among which two were clicking and the other 10 had mild crepitus. The intensity of the postoperative residual noise was significantly decreased in all cases compared to that in the preoperative condition. Among patients with MOL below 38 mm (n = 18), the mean MMO was 31.4 mm preoperatively and 44.2 mm at 6 months postoperatively, with a mean increase of 13.8 mm. A barely visible scar at the operation site was noted during the postoperative observation period, with no significant complications such as facial palsy or permanent occlusal disharmony. Conclusion Subjective symptoms in all patients improved following the surgery. TMJ disc plication using MITEK mini anchors with our minimally invasive approach may be a feasible and effective surgical option for treating TMJ ID patients who are not responsive to conservative treatment.

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“…The clinical and experimental results showed that disc displacement could cause an increased load on the condyle and promote it to resorb and degenerate to osteoarthritis or even ankylosis131415161718192021. Our previous clinical observation showed that disc repositioning could stimulate condyle growth in growing patients16.…”

Section: Discussionmentioning

confidence: 98%

Acute trauma induced disc displacement without reduction and its sequelae

Yang

Wang

et al. 2016

Sci Rep

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Acute traumatic temporomandibular joint disc displacement (ATDD) and its sequelae are not familiar for most surgeons. This study is to discuss its sequelae in cases without disc reduction after failed conservative treatment. From 2010 to 2015, 26 patients with 34 joints were included in the study. All patients had at least 3 months conservative treatment. Their maximal incisor opening (MIO) was measured during follow-ups and MRI examination was used to check the condylar bone degeneration. The mean follow-up for conservative treatment after admission was 8.69 months, the patients reached an average of 25.7 mm MIO. MRI showed condylar bone intact in 8 joints (23.5%), condylar surface bone destruction (Wilks IV, V stages) in 14 joints (41.2%), and severe bone resorption in 12 joints (35.3%). 15 patients with 23 joints were asked for surgical treatment after a mean conservative treatment of 5.4 months (3–12 months) to improve mouth opening and relieve chronic pain. 12 joints had total joint replacement (TJR). 11 joints had disc repositioning. Their mean MIO before operation was 19.8 mm and significantly improved to 33.9 mm after operation (p = 0.0000). ATDD may cause severe osteoarthritis or ankylosis. Disc repositioning and TJR could significantly improve MIO.

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Disc Repositioning

Cited by 47 publications

References 65 publications

Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series

Effectiveness of Sequential Viscosupplementation in Temporomandibular Joint Internal Derangements and Symptomatology: A Case Series

Temporomandibular joint disc plication with MITEK mini anchors: surgical outcome of 65 consecutive joint cases using a minimally invasive approach

Acute trauma induced disc displacement without reduction and its sequelae

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