Simple disc reshaping surgery for internal derangement of the temporomandibular joint: 5-year follow-up results.
OBJECTIVE
The goal of this study was to evaluate the clinical results of simple disc reshaping (SDR) surgery alone for treating dysfunctional internal derangement of the temporomandibular joint.


METHODS
Eleven patients with symptomatic unilateral anterior disc displacement with disc deformation were treated using reshaping of the inferior surface of the disc without disc repositioning. This was performed as an open-joint procedure. All patients were evaluated clinically for joint pain and jaw motion 5 years after surgery. Structural changes of the joint tissues such as disc displacement and deformation were evaluated using magnetic resonance imaging. The postoperative results were compared with preoperative findings.


RESULTS
Joint pain during mastication or opening was reported by all patients before surgery. In 10 of 11 patients (91%), the joint pain disappeared postoperatively. Preoperatively, all 11 patients had limitation of mouth opening: the mean opening was 24.9 mm (standard deviation [SD], 4.13 mm). Postoperatively, the mean opening increased to 43.0 mm (SD, 3.00 mm). Based on the preoperative magnetic resonance imaging, all cases were diagnosed as anterior disc displacement without reduction and with disc deformation. Five years postoperatively, the disc configuration had maintained the reshaped status with decreased thickness of the deformed disc in 5 patients, and was changed to an almost normal biconcave shape in 3 patients. In the remaining 3 patients, the disc was unchanged from its preoperative condition. The position of the disc was unchanged in 8 patients, and in 3 patients disc position improved to near normal.


CONCLUSIONS
The 5-year follow-up results suggest that SDR is a stable and favorable surgical procedure. Successful outcomes were attained in 91% of the patients.
Kondoh
Toshirou
T
First Department of Oral and Maxillofacial Surgery, School of Dentistry, Tsurumi University, Yokohama, Japan. kondo-t@tsurumi-u.ac.jp
Hamada
Yoshiki
Y
Kamei
Kazutoshi
K
Seto
Kanichi
K
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008335:Mandibular Condyle / Q000473:pathology / Q000503:physiopathology; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D009068:Movement; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D019224:Temporomandibular Joint Disc / Q000473:pathology / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery; D016896:Treatment Outcome