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. 2022 Feb 24;12(1):3194.
doi: 10.1038/s41598-022-07014-9.

Prognostic indicators of arthroscopic discopexy for management of temporomandibular joint closed lock

Manoj Kumar Sah #  1   2   3 , Ahmed Abdelrehem #  1   2   3   4 , Shihui Chen  1   2   3 , Pei Shen  1   2   3 , ZiXian Jiao  1   2   3 , Ying Kai Hu  1   2   3 , Xin Nie  5 , Chi Yang  6   7   8
Affiliations

Prognostic indicators of arthroscopic discopexy for management of temporomandibular joint closed lock

Manoj Kumar Sah et al. Sci Rep. .

Abstract

In order to optimize patient selection for temporomandibular joint (TMJ) arthroscopic discopexy to achieve favorable outcomes, prognostic indicators impacting the results are important to analyze. This longitudinal retrospective study aimed to analyze various prognostic factors impacting surgical outcomes following arthroscopic discopexy for management of TMJ closed lock using success criteria based on pain, maximal interincisal opening, diet, and quality of life. Furthermore, a quantitative MRI assessment was performed pre- and post-operatively. Multivariate analysis was used to evaluate various prognostic variables including gender, age, side, duration of illness, Wilkes staging, parafunctional habits, splint therapy and orthodontic treatment. A total of 147 patients (201 joints) were included. The outcome was categorized as excellent (n = 154/76.61%), good (n = 34/16.91%), or poor (n = 13/6.46%) with a success rate of 93.54%. Patients aged > 30 years old (p = 0.048), longer duration of illness (12-24 months: p = 0.034) and (> 24 months: p = 0.022), and patients with Wilkes stage IV (p = 0.002) were all significantly more likely to be in the poor outcome group. Finally, orthodontic treatment showed a significant association with excellent outcomes (p = 0.015). Age, duration of illness, Wilkes staging, and orthodontic treatment are considered significant prognostic factors that can predict the outcomes following the arthroscopic discopexy for management of TMJ closed lock.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study design and workflow analysis of prognostic variables.
Figure 2
Figure 2
An illustrated diagram demonstrating the key reference points on MRI measurements before surgery. (A): A preoperative MRI sagittal view; (B): A schematic diagram showing reference points and lines for condylar height measurement; (C): A schematic diagram demonstrating reference points and lines for measurement of disc displacement distance.
Figure 3
Figure 3
An illustrated diagram demonstrating the key reference points on MRI measurements after surgery. (A): A postoperative MRI sagittal view; (B): A schematic diagram showing reference points and lines for condylar height measurement; (C): A schematic diagram demonstrating reference points and lines for measurement of disc reposition distance.
Figure 4
Figure 4
MRI scans of a 17-year-old female patient with ADD on the left side. (A) Preoperative MRI image, (B) Immediate postoperative MRI image showing successful disc repositioning, (C) Stable disc position with condylar bone remodeling at 24 months of postoperative follow-up.
See this image and copyright information in PMC

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