title: Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results.
abstract: OBJECTIVE
  Anterior disk dislocation (ADD) without reposition in the temporomandibular joint (TMJ) may be associated with morphological changes in the retrodiscal region of the bilaminar zone presenting as pseudo-disk (PD). The present study was initiated to investigate the development of retrodiscal fibrosis in a period of 4-8 years and to assess if patients with a PD show differences in the clinical and radiologic findings versus patients without a PD.
  
  
  METHODS
  In a retrospective follow-up study of 33 consecutive patients with ADD without reposition in one or both TMJs, a clinical and MRI-supported evaluation was conducted 4 to 8 years after baseline diagnosis.
  
  
  RESULTS
  In 45 % of the TMJs with ADD without reposition, a PD could be identified. Twenty-one of 31 patients who showed pain at the baseline examination (VAS mean 56 ± 38) were pain free. The mouth opening capacity (MO) of the mandible could be increased in 80 %. There were no statistical significant differences between patients with or without PD in these clinical features. The MRI parameters effusion and translation showed a statistical tendency for more improvement in the group with PD (p = 0.061, 0.064).
  
  
  CONCLUSIONS
  In about half of the patients, a structure corresponding to a pseudo-disk developed during follow-up. Pain and the mouth opening capacity improved in all patients independent of the development of a PD.
  
  
  CONCLUSIONS
  Detection of a PD during follow-up of patients with ADD without spontaneous reposition does neither predict favorable nor worse therapy response and clinical course.
authors.affiliation: Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria. margit.bristela@meduniwien.ac.at.
authors.forename: M
authors.initials: M
authors.lastname: Bristela
authors.affiliation: Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Schmid-Schwap
authors.affiliation: Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Eder
authors.affiliation: Dental Office, Vienna, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Reichenberg
authors.affiliation: Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Wien, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Kundi
authors.affiliation: Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Piehslinger
authors.affiliation: Diagnostic Center Urania, Laurenzerberg 2, 1010, Vienna, Austria.
authors.forename: S
authors.initials: S
authors.lastname: Robinson
mesh_terms: D000328:Adult; D000368:Aged; D001317:Austria; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*
keywords: Disk displacement without reposition; Disk position; MRI; Pseudo-disk; TMD