Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up

Rationale: Occlusal appliance is one of methods for temporomandibular joint anterior disc displacement with reduction (ADDWR). However, most studies have focused on the symptom reliefs rather than the disc-condyle positional relationship. Aim: To evaluate the success rate and the prognosis of occlus...

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Main Authors: Ch. Yang, P. Shen
Format: Article
Language:Russian
Published: MONIKI 2017-12-01
Series:Alʹmanah Kliničeskoj Mediciny
Subjects:
Online Access:https://www.almclinmed.ru/jour/article/view/630
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author Ch. Yang
P. Shen
author_facet Ch. Yang
P. Shen
author_sort Ch. Yang
collection DOAJ
description Rationale: Occlusal appliance is one of methods for temporomandibular joint anterior disc displacement with reduction (ADDWR). However, most studies have focused on the symptom reliefs rather than the disc-condyle positional relationship. Aim: To evaluate the success rate and the prognosis of occlusal appliances in repositioning of the disc in temporomandibular joint ADDWR. Materials and methods: One hundred and forty four (144) patients (210 joints) diagnosed with temporomandibular joint ADDWR based on magnetic resonance imaging (MRI) were consecutively included in our study. For all joints it was confirmed by MRI that the disc could be recaptured in a mandible anterior position. Occlusal appliances, including anterior repositioning appliance, twinblock or Herbst, were worn to keep the mandible in this position. MRI scanning was carried out before, 6 months later, at the end of treatment and at the follow-up visit. Logistic regression was used to analyze the risk factors for success. Cox regression model was applied to estimate the prospective risk of failure. Results: Among the occlusal appliances used, there were 100 anterior repositioning appliances, 23 twin-blocks, and 21 Herbst, with mean treatment duration of 9.5 ± 2.6 months. One hundred and seventy seven (177) joints (84.3%) were successfully repositioned at the end of splint treatment, according to MRI. Logistic regression showed that the appliance types were significantly associated with the success rate. At 2 years of regular follow-up, in almost 53% of the cases the disc-condyle relationship was normal. Gender, age, treatment duration and orthodontics were identified in the final Cox regression model with hazard ratios of 1.375, 1.141, 0.396 and 0.364 respectively. Conclusion: Occlusal appliance is one of the useful methods to recapture the disc in patients with temporomandibular joint ADDWR. However, the patient selection should be rigorous.
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spelling doaj.art-79d28c8de5ce49cc8657483d62b3d9062022-12-21T22:11:35ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942017-12-0145647848510.18786/2072-0505-2017-45-6-478-485482Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-upCh. Yang0P. Shen1Shanghai Jiao Tong University School of MedicineShanghai Jiao Tong University School of MedicineRationale: Occlusal appliance is one of methods for temporomandibular joint anterior disc displacement with reduction (ADDWR). However, most studies have focused on the symptom reliefs rather than the disc-condyle positional relationship. Aim: To evaluate the success rate and the prognosis of occlusal appliances in repositioning of the disc in temporomandibular joint ADDWR. Materials and methods: One hundred and forty four (144) patients (210 joints) diagnosed with temporomandibular joint ADDWR based on magnetic resonance imaging (MRI) were consecutively included in our study. For all joints it was confirmed by MRI that the disc could be recaptured in a mandible anterior position. Occlusal appliances, including anterior repositioning appliance, twinblock or Herbst, were worn to keep the mandible in this position. MRI scanning was carried out before, 6 months later, at the end of treatment and at the follow-up visit. Logistic regression was used to analyze the risk factors for success. Cox regression model was applied to estimate the prospective risk of failure. Results: Among the occlusal appliances used, there were 100 anterior repositioning appliances, 23 twin-blocks, and 21 Herbst, with mean treatment duration of 9.5 ± 2.6 months. One hundred and seventy seven (177) joints (84.3%) were successfully repositioned at the end of splint treatment, according to MRI. Logistic regression showed that the appliance types were significantly associated with the success rate. At 2 years of regular follow-up, in almost 53% of the cases the disc-condyle relationship was normal. Gender, age, treatment duration and orthodontics were identified in the final Cox regression model with hazard ratios of 1.375, 1.141, 0.396 and 0.364 respectively. Conclusion: Occlusal appliance is one of the useful methods to recapture the disc in patients with temporomandibular joint ADDWR. However, the patient selection should be rigorous.https://www.almclinmed.ru/jour/article/view/630temporomandibular jointanterior disc displacement with reductionmandibleocclusal appliancesanterior repositioning appliancetwin-blockherbstmagnetic resonance imaging
spellingShingle Ch. Yang
P. Shen
Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
Alʹmanah Kliničeskoj Mediciny
temporomandibular joint
anterior disc displacement with reduction
mandible
occlusal appliances
anterior repositioning appliance
twin-block
herbst
magnetic resonance imaging
title Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
title_full Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
title_fullStr Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
title_full_unstemmed Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
title_short Assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction: a 3 to 36 months follow-up
title_sort assessment of occlusal appliance in repositioning of the temporomandibular joint anterior disc displacement with reduction a 3 to 36 months follow up
topic temporomandibular joint
anterior disc displacement with reduction
mandible
occlusal appliances
anterior repositioning appliance
twin-block
herbst
magnetic resonance imaging
url https://www.almclinmed.ru/jour/article/view/630
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