Correlation Between The Classification Of Anterior Disc Displacement Of The Temporomandibular Joint And Major Clinical Symptoms

Objective: In this study,patients who had symptoms of temporomandibular disorders were clinically selected from September 2015 to March 2019 to the Department of Oral and Maxillofacial Surgery,the First Affiliated Hospital of Wannan Medical College.The magnetic resonance imaging of the temporomandibular joint area was performed,and the results of the examination were evaluated.According to the clinical data collected,there were many patients with anterior disc displacement of the temporomandibular joint in the clinic.Therefore,31 patients who underwent MRI and were diagnosed with anterior disc displacement of the temporomandibular joint were selected.According to the accepted diagnostic criteria of MRI,the anterior disc displacement of the temporomandibular joint was divided into anterior disc displacement with reduction and anterior disc displacement without reduction.We hope to confirm the four clinical symptoms alone or the combined can help us to diagnose the anterior disc displacement of the temporomandibular joint with reduction or without reduction in the clinical.Method:1.Inclusion criteria: 1)Clinically,symptoms of temporomandibular disorder,and diagnosis the anterior disc displacement of the temporomandibular joint in the MRI;2)All patients were voluntarily undergoing MRI examination.2.Diagnostic criteria:MRI diagnostic criteria for anterior disc displacement of the temporomandibular joint in magnetic resonance imaging: in the closed sagittal position,there is a clear boundary between the posterior disc and the double plate(the disc boundary),the posterior disc is located at the top of the condyle,the disc boundary and the condyle The angle formed by the 12 o’clock vertical line(the disc boundary line angle)is defined as the normal disk condyle relationship(NDCR)within 10° of the front and rear;the forward disc exceeding the disc boundary angle of 10° is defined as the disc advancement.Position,open oblique sagittal image joint disc-condyle position relationship returned to normal,defined as anterior disc displacement with reduction(ADDR);open oblique sagittal image joint disc-condyle positional relationship cannot be restored to normal,and the articular disc is still in front of the condyle,defined as anterior disc displacement without reduction(ADDWR).3.Medical history records: record the patient’s current medical history,past history and general examination,record the clinical symptoms of the patient.4 Quality Control: The members of this research group need two facilitators and medical records management personnel in addition to the researchers.Select the medical record in strict accordance with the diagnostic inclusion criteria,the patient case number that meets the standard before the study,through the clinical examination,register the basic data of the case,and check the patient information,symptoms and examination results entered into the database,and improve the relevant diagnosis(by the researcher and the imaging department)Director Jian Jian together read the film,diagnosed and follow-up treatment measures to ensure the authenticity and reliability of the data entered.Based on the diagnosis,it was evaluated whether there was a correlation between anterior disc displacement with reduction or without reduction and major clinical symptoms.Results:1.A total of 31 cases were collected in this study,including 8 males and 23 females.The male-female ratio was 1:2.875,the youngest was 17 years old,the largest was 64 years old,and the average age was 29.35 years old.Clinically,the main symptoms include click noise,pain,limitation of mouth opening and limitation of jaw jaw movement.There are 25 cases(80.6%)with click noise,of which 17 cases(54.8%)diagnosed with ADDWR and 6 cases(19.3%)diagnosed with ADDR,there were 2 cases(6.4%)with ADDR and ADDWR;And 24 cases(77.4%)with pain,among them,16 cases(51.6%)diagnosed with ADDWR and 6 cases(19.3%)diagnosed with ADDR,there were 2cases(6.4%)with ADDR and ADDWR;21 cases(67.7%)with limitation of mouth opening,among them,12 cases(38.7%)diagnosed with ADDWR,6 cases(19.3%)with ADDR,and there were 3 cases(9.6%)diagnosed with ADDR and ADDWR;16 cases(51.6%)with limitation of jaw jaw movement,among them,9 cases(29%)diagnosed with ADDWR,4 cases(12.9%)diagnosed with ADDR,and 3 cases(9.6%)with ADDR and ADDWR.In this experiment,there were 31 patients(100%)with anterior disc displacement of the temporomandibular joint.Of the 31 patients,4cases(12.9%)had the above four symptoms,which 4 cases(12.9%)was diagnosed with ADDWR,there were 0cases(0%)diagnosed with ADDR,and 0 cases(0%)with ADDR and ADDWR;There are15 cases(48.3%)of the above three symptoms,of which 7 cases(22.5%)diagnosed with ADDWR,6 cases(19.3%)diagnosed with ADDR,and 2 cases(6.4%)with ADDR and ADDWR;There were 12 cases(38.7%)of the two symptoms,of which 9 cases(29%)diagnosed with ADDWR,2 cases(6.4%)diagnosed with ADDR,and 1 case(3.2%)with ADDR and ADDWR;The single patient with the above symptoms was 0(0%).2.In 31 patients with anterior disc displacement of the temporomandibular joint,statistically,the association between pain and anterior disc displacement of the temporomandibular joint(ADDR,ADDWR,ADDR and ADDWR)P=0.835*>0.05,no statistical significance;association between click noise and anterior disc displacement of the temporomandibular joint(ADDR,ADDWR,ADDR and ADDWR)P=0.489* >0.05,no statistical significance;correlation between limitation of mouth opening and anterior disc displacement of the temporomandibular joint(ADDR,ADDWR,ADDR and ADDWR)P=0.608*>0.05,none Statistical significance;the association between limitation of jaw jaw movement and anterior disc displacement of the temporomandibular joint(ADDR,ADDWR,ADDR and ADDWR)was P=0.768*>0.05,which was not statistically significant.3.In 31 patients with anterior disc displacement of the temporomandibular joint,statistically,There was a correlation between the four clinical symptoms in combination and anterior disc displacement of the temporomandibular joint(ADDR,ADDWR,ADDR and ADDWR)P=0.413*>0.05,no statistical significance.Patients who cannot be used for the diagnosis of anterior disc displacement of the temporomandibular joint with reduction or without reduction when the clinical patients have joint symptoms of click noise,pain limitation of mouth opening and limitation of jaw jaw movement.Discussion: Clinical symptoms have a certain effect on the diagnosis of anterior disc displacement of the temporomandibular joint.The Four symptoms of click noise,pain limitation of mouth opening and limitation of jaw jaw movement alone or in combination can not be used for the diagnosis of anterior disc displacement with or without reduction;In order to clarify the classification of the anterior disc displacement of the temporomandibular joint,it is still necessary to determine by MRI,and the importance of magnetic resonance imaging for the diagnosis of anterior disc displacement of the temporomandibular joint is demonstrated from the reverse side.