Prognosis and Factors Influencing Temporomandibular Joint Degenerative Disease in Adolescents: A Retrospective Study.

Abstract

Background: Few studies have addressed the prognosis of temporomandibular joint degenerative joint disease (TMJ-DJD) in adolescents.

Objective: To retrospectively analyse clinical and imaging data of adolescent patients (10-19 years) with TMJ-DJD who had multiple follow-up visits, focusing on condylar bone outcomes and influencing factors.

Methods: Clinical records and CBCT scans of adolescent TMJ-DJD patients were reviewed. The condylar surface was divided into nine regions to assess the severity of and changes in TMJ-DJD. Bone outcomes (improvement, no change, worsening) at different follow-up intervals (3-6, 7-12, 13-24 months and over 24 months) were analysed for early- and late-stage TMJ-DJD. Logistic regression was employed to identify key factors affecting bone changes.

Results: In total, 378 patients (62 males and 316 females; 15.36 ± 2.29 years) were included. The proportions of improvement, no change and worsening were 46.8%, 35.7% and 17.5% at 3-6 months follow-up, respectively. After over 24 months of follow-up, these proportions shifted to 64.5%, 18.1% and 17.4%. A significantly greater proportion of early-stage patients than that of late-stage patients improved: 56.5% vs. 34.5% at 3-6 months and 77.4% vs. 56.5% at over 24 months, respectively (p = 0.0167). Late-stage DJD yielded a greater proportion of stable bone conditions. Logistic regression indicated that unilateral involvement (OR = 2.323, p = 0.005) and anterior repositioning splint (ARS) combined with manual disc reduction (OR = 2.785, p = 0.045) significantly influenced bone outcomes.

Conclusion: Adolescent TMJ-DJD patients show a progressive improvement in bone outcomes. Early-stage TMJ-DJD exhibits more significant improvement compared to late-stage TMJ-DJD, which tends to remain stable. Unilateral TMJ-DJD and ARS significantly enhance bone improvement.