Temporomandibular joint disc repositioning with MITEK miniscrew anchor: a medium-term follow-up clinical and MR study

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.