Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results

Objectives 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 48 years and to assess if patients with a PD show differences in the clinical and radiologic findings versus patients without a PD. Materials and 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). Conclusion 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. Clinical Relevance 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.(VLID)349719