engleski

Temporomandibular Joint Disorder Confirmed by MRI in Adolescents with 1-year-follow-up of Treatment

Objectives:Temporomandibular joint disorder (TMJ) affects patients from the age of permanent dentition to old age. The most common diagnoses of TMJ are anterior disc displacement and osteoarthritis (OA). The aim of the study was to analyze the adolescent patient with respect to the diagnosis of TMJ, as well as the success of the therapy after one year of follow-up. Materials and methods: From 2001 to 2019, a total of 365 patients were included in the study, who sought help due to the painful symptoms of TMJ. This study included patients (n = 42, mean age 16.9 ± 2.0 years ; 88.1% female) with a range of 12 to 19 years. The definitive diagnosis was confirmed by magnetic resonance imaging (MRI). All patients had painful symptoms of TMJ (pain intensity was measured by an analog-visual scale, VAS 0-10). Patients were initially treated with the Schulte splint and / or physical therapy, and follow-up was performed 6 months and 1 year after the first examination. Results: In adolescents, there were two subgroups of the same mean age of 17.42 ± 2.06 years for both subgroups (p = 0.0647): 19 patients with disc displacement and 23 patients with OA. Pain on VAS at the first examination / after 6 months / after 1 year for the subgroup of disc displacement was 5.98 ± 1.4 / 2.95 ± 2.8 / 1.00 ± 1.4, while for the subgroup of OA it was 6.11 ± 1.1 / 2.66 ± 2.1 / 1.11 ± 1.8. There was no statistically significant difference between subgroups (p> 0.05). The success of the treatment was the same for both subgroups: for disc displacement a total of 63.1% and for OA a total of 69.5% of patients. For each subgroup, observed separately, a significant progress was made in healing (p <0.0001). Conclusions: the displacement of the disc along with the occurrence of degenerative painful changes in the adolescent reveal that OA is not just a disease of old age. MRI is considered the radiological diagnostic gold standard. The method is non-invasive, non-ionizing and relatively comfortable for soft tissue imaging. A limitation is a weaker capacity of hard tissue imaging, but for the youngest age groups CBCT is not ethically applicable. In this study, the success of therapy in the subgroup with OA was somewhat slower.

magnetic resonance imaging ; temporomandibular joint ; anxiety

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