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Changes in condylar mobility and radiographic alterations after treatment in patients with non-reducing disc displacementof the temporomandibular joint

Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi Aoba-ku, Sendai 980-8575, Japan

*Correspondence to: Dr Shuichi Sato, Division of Maxillofacial Surgery, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi Aoba-ku, Sendai 980-8575, Japan; Email: shuichi-sato{at}umin.ac.jp

Received 29 March 2005; revised 17 October 2005; accepted 30 October 2005

Objectives: The purpose of this study was to examine changes in condylar mobility and morphological changes in the affected condyles after treatment in patients with non-reducing disc displacement of the temporomandibular joint (TMJ).

Methods: Changes in condylar mobility and morphological changes of the condyle were examined radiographically in 55 patients who were diagnosed as having non-reducing disc displacement of the unilateral TMJ and had received pumping with injection of sodium hyaluronate. In all patients, standardized lateral oblique transcranial radiographs and panoramic jaw tomograms were taken both at initial visit and at 12 months or more follow-up (mean 28.1 months after treatment; range 12–104 months). 42 joints in 21 persons with no current or previous TMJ symptoms served as a control.

Results: Clinical signs and symptoms improved after treatment in the patients. Condylar mobility significantly increased after treatment in patients (P<0.001), although it did not reach levels of the control group. Frequency of radiographic changes of the condyle significantly increased after treatment (P<0.005). In most of the patients, no or only mild changes were observed. Frequency of changes of the condyle in patients at follow-up was significantly greater than that in controls (P<0.001).

Conclusions: In the patients, condylar mobility increased in the subsequent course after treatment. However, bony changes of the condyle appeared more frequently. Long term-follow-up after treatment on bony changes of the condyle seems to be necessary in patients with non-reducing disc displacement of the TMJ.

Keywords: temporomandibular disorders; internal derangement of the temporomandibular joint; condylar mobility; radiographic changes