Clinical and MRI Predictors of Successful Mandibular Manipulation Therapy in Anterior Disc Displacement Without Reduction.

Abstract

Objective: To identify clinical and imaging predictors influencing the success rate of disc reduction following mandibular manipulation (MM).

Methods: Participants with anterior disc displacement without reduction (ADDwoR) who visited Peking University Hospital of Stomatology and underwent MM assisted by arthrocentesis were included. Demographic, clinical, and imaging data of all participants were collected. Qualitative and quantitative assessments were conducted. All statistical analyses were performed using IBM SPSS Statistics version 27.0.

Results: A total of 197 patients were included in the study, with 71.6% achieving successful disc reduction (DR). The average age of all participants was 23.45 ± 8.83 years, with 89.3% being female. The multivariate logistic model revealed that angle β (OR = 1.04; 95% CI = 1.01-1.07) and disc length (OR = 1.57; 95% CI = 1.15-2.15) were significantly associated with increased odds of successful disc reduction, while duration of jaw lock (OR = 0.66; 95% CI = 0.53-0.80) and thickness of the intermediate zone (OR = 0.26; 95% CI = 0.09-0.75) were significantly associated with decreased odds.

Conclusions: Shorter duration of jaw lock, milder disc deformation, and less severe disc displacement indicate higher success rates of disc reduction using MM. The established cut-off values were 2.75 months for disease duration of jaw lock, 8.39 mm for disc length and 96.7° for the intersection angle β. Future development of a multivariate prediction model may help optimize clinical management strategies for ADDwoR.