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Arthroscopic reduction and rigid fixation of the anteriorly displaced temporomandibular joint disc without reduction using titanium screw: a case series

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Abstract

Objectives

To evaluate the effectiveness of arthroscopic reduction and rigid fixation (ARRF) using a suture-free titanium screw as a treatment approach to temporomandibular joint’s (TMJ) anterior disc displacement without reduction (ADDwoR) and assess its impact on clinical outcomes, including improvements in symptoms related to TMJ disorders.

Materials and methods

A series of twenty patients presented to the Department of Orthognathic and Temporomandibular Surgery at West China Hospital of Stomatology between September 2022 and January 2023, complaining of symptoms such as pain, clicking, and limited mouth opening. Standard magnetic resonance image (MRI) imaging T1 and T2 sequences in both sagittal and coronal views study with closed and maximal open mouth positions were taken preoperatively to assess the disc’s position, integrity, and shape. Also, cone-beam computed tomography (CBCT) scans images to find any degenerative changes and evaluate the condylar bone’s features and volume. Additionally, the clinical examination assesses limited oral opening, mechanical pain, and the presence of any noises such as clicking and crepitus. All cases were treated under general anesthesia using the arthroscopic release, reduction, and rigid fixation of the TMJ’s ADDwoR to establish a normal disc-condyle relationship and to restore the functional position.

Results

Patients’ symptoms, such as pain and mouth opening, improved significantly following the arthroscopic treatment. Postoperative MRI and CBCT imaging follow-up conducted at 6 months demonstrated the stable position of the reduced TMJ disc and the fixation screw. Notably, none of the patients exhibited signs of relapse during this follow-up period.

Conclusion

Overall, the ARRF of TMJ’s ADDwoR using a suture-free titanium screw proved to be safe and provides satisfactory results, in addition to the several advantages of using suture-free titanium screws, such as biocompatibility, strong fixation, and durability. However, it is a technically demanding procedure requiring extensive, long-term training.

Clinical relevance

ARRF using a cost-effective fixation titanium screw to treat ADDwoR emerges as a clinically effective minimally invasive approach.

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Funding

This study was supported by the National Natural Science Foundation of China (NSFC) under grant number 82071139 and the Key Research and Development Program of the Sichuan Provincial Department of Science and Technology under grant number 23ZDYF2130.

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Authors and Affiliations

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3 of Renmin Nan Road, Chengdu, 610041, Sichuan, China

    Yao Liu, Peng Wang, Wael Telha, Nan Jiang, Ruiye Bi & Songsong Zhu

Authors
  1. Yao Liu
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  2. Peng Wang
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  3. Wael Telha
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  4. Nan Jiang
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  6. Songsong Zhu
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Contributions

Yao Liu: Conceptualization, Patient treatment, Data curation, original draft preparation, review, and editing.

Peng Wang: Conceptualization, Patient treatment, Data curation, review and editing.

Wael Telha: Conceptualization, Patient treatment, original draft preparation, review, and editing.

Ruiye Bi: Conceptualization, Patient treatment, original draft preparation, review, and editing.

Nan Jiang: Conceptualization, Patient treatment, original draft preparation, review, and editing.

Songsong Zhu: Project administration, Reviewing and Editing, Supervision.

Y.L: conceptualization, patient treatment, data curation, original draft preparation, review, and editing. P.W: conceptualization, patient treatment, data curation, review and editing. W.T: conceptualization, patient treatment, original draft preparation, review and editing. R.B: conceptualization, patient treatment, original draft preparation, review and editing. N.J: conceptualization, patient treatment, original draft preparation, review and editing. S.Z: project administration, reviewing and editing, supervision.

Corresponding author

Correspondence to Songsong Zhu.

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Competing interests

The authors declare no competing interests.

Conflict of interest

All authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

This study was conducted in compliance with the Declaration of Helsinki and was approved by the regional ethics review board of West China Hospital of Stomatology (WCHSIRB-CT-2022–375).

Consent to participate

Written informed consent was obtained from all individual participants involved in the study.

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Liu, Y., Wang, P., Telha, W. et al. Arthroscopic reduction and rigid fixation of the anteriorly displaced temporomandibular joint disc without reduction using titanium screw: a case series. Clin Oral Invest 28, 156 (2024). https://doi.org/10.1007/s00784-024-05552-2

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