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      Temporomandibular joint disc repositioning with mitek miniscrew anchor: a medium-term follow-up clinical and mr study Translated title: Reposicionamiento meniscal de la articulación temporomandibular con minitornillos de anclaje MITEK: estudio clínico y por RM a medio plazo

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          Abstract

          ABSTRACT Introduction: Anterior disc displacement is the most frequent internal derangement of the TMJ. It can ultimately lead to progressive joint dysfunction. Several disc repositioning techniques have been described, both open and arthroscopic. There is a lack of consensus regarding the success of open disc repositioning. Nonetheless, many authors have reported satisfactory results. Material and methods: We report our experience with disc repositioning using the MITEK mini anchor in 25 patients. Preoperative pain measured by the VAS scale, clicking and TMJ related symptoms were recorded, as well as mean mouth opening. Patients underwent a postoperative MRI to analyze disc position at 1 year after surgery. Results: Five patients (20 %) presented with persistent pain after surgery and ten patients (40 %) referred persistent clicking at the longest follow-up. Preoperative mean maximum mouth opening was 29,28 mm, which increased to 36,08 mm one-year postoperatively. Mean pain as measured by the VAS scale decreased to 2,40 after surgery, with a total decrease of 4,16 points. On MRI, 23 of 30 discs were correctly positioned (76,66 %) at 1 year after surgery. Conclusion: Disc repositioning has shown to significantly decrease pain and TMJ-related symptoms. However, we found that there is a remarkable clinical and radiological discrepancy that must be taken into account.

          Translated abstract

          RESUMEN Introducción: El desplazamiento anterior del disco es el trastorno interno más frecuente de la ATM. Si evoluciona, puede provocar una disfunción articular progresiva. Se han descrito varias técnicas de reposicionamiento del disco, tanto abiertas como artroscópicas. Sin embargo, existe una falta de consenso respecto a la eficacia de la cirugía abierta para reposicionamiento meniscal, a pesar de que en la literatura muchos autores han demostrado resultados satisfactorios. Material y métodos: Presentamos nuestra experiencia con el reposicionamiento meniscal utilizando MITEK en 25 pacientes. Se registró el dolor preoperatorio medido por la escala EVA, los clics y los síntomas relacionados con la ATM, así como la apertura oral media. Los pacientes fueron sometidos a una resonancia magnética postoperatoria para analizar la posición del disco un año después de la cirugía. Resultados: Cinco pacientes (20 %) presentaron dolor persistente después de la cirugía y diez pacientes (40 %) refirieron clics persistentes al final del seguimiento. La apertura oral media máxima preoperatoria fue de 29,28 mm, que aumentó a 36,08 mm un año después de la cirugía. El dolor medio medido por la escala EVA disminuyó a 2,40 después de la cirugía, con una disminución total de 4,16 puntos. En la resonancia magnética, 23 de los 30 discos (76,66 %) estaban adecuadamente posicionados 1 año después de la cirugía. Conclusión: Se ha demostrado que el reposicionamiento del disco reduce significativamente el dolor y los síntomas relacionados con la ATM. Sin embargo, encontramos que existe una notable discrepancia clínica y radiológica que debe tenerse en cuenta.

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          Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings.

          This study was performed to investigate the relationships between disk displacement, joint effusion, and degenerative changes in patients with temporomandibular disorders using MRI. Randomly selected MRIs of 508 temporomandibular joints of 254 patients (92 males and 162 females, mean age was 30.5±12.0 years) were reviewed retrospectively. Seventy-eight percent (198 out of 254) of the patients complained of joint pain. Compared with joints with a normal disk position, the joints with anterior disk displacement with reduction showed a 2.01 odds ratio (P<0.01) of degenerative changes and a 2.85 odds ratio (P<0.001) of joint effusions. The joints with anterior disk displacement without reduction showed a 4.43 odds ratio (P<0.001) of degenerative changes and a 4.61 odds ratio (P<0.001) of joint effusions. These results clearly show that the risk of degenerative changes and joint effusions increase with displacement of the disk position in patients with temporomandibular disorders. Although all disk displacement situations do not progress to painful joints and/or degenerative joint diseases, the possibility of an increased risk of progression by a breakdown in the balance between a patient's adaptive capacity and functional loading of the TMJ should be assessed in each and every patient through comprehensive evaluation of various contributing factors.
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            Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study.

            To quantitatively assess the changes in disc position relative to the condyle, disc length, and condylar height, with magnetic resonance imaging in patients with anterior disc displacement of the temporomandibular joint who had received no treatment, to provide useful information regarding treatment planning.
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              The Mitek mini anchor for TMJ disc repositioning: surgical technique and results.

              This study evaluated our treatment outcomes in 105 patients (188 discs) using the Mitek mini anchor for temporomandibular joint (TMJ) articular disc repositioning surgery, with 88 patients having simultaneous orthognathic surgery. Criteria for inclusion into the study were: (1) Presurgical TMJ disc displacement with salvageable disc; (2) No prior TMJ surgery; (3) TMJ disc repositioning with the Mitek mini anchor; (4) Absence of connective tissue/autoimmune disease; (5) Absence of postsurgical trauma; and (6) Minimum of 12 months postsurgery follow up. Presurgery (T1), immediately postsurgery (T2), and longest follow up (LFU) clinical and radiographic evaluations were performed. The mean age of the patients was 32.6 years (range 14-57 years), and mean follow-up time was 46.2 months (range 14-84 months). Radiographic evaluation at LFU demonstrated no significant condylar resorption or positional changes of the anchors. At LFU, there was a statistically significant reduction in: TMJ pain, facial pain, headaches, TMJ noises and disability, and improvement in jaw function and diet. Maximum incisal opening improved slightly and lateral excursive movements decreased slightly. The Mitek mini anchor provides a predictable method for stabilizing the TMJ articular disc to the condyle and a high success rate in decreasing TMJ dysfunction and pain in patients with no previous TMJ surgery.
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                December 2021
                : 43
                : 4
                : 134-139
                Affiliations
                [2] Madrid orgnameHospital La Luz orgdiv1Servicio de Cirugía Oral y Maxilofacial España
                [1] Madrid orgnameHospital Universitario La Paz orgdiv1Servicio de Cirugía Oral y Maxilofacial España
                Article
                S1130-05582021000400003 S1130-0558(21)04300400003
                10.20986/recom.2021.1298/2021
                01893588-e97d-4946-9eae-53da13a3d0f3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 26 October 2021
                : 29 June 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 6
                Product

                SciELO Spain

                Categories
                Originals

                Disc repositioning,meniscopexy,MITEK anchor,Reposicionamiento meniscal,meniscopexia,MITEK

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