Clinical oral investigations · 2026
Correlation between MRI disc morphology and temporomandibular joint osteoarthritis in patients with temporomandibular joint disc displacement with reduction: a cross-sectional CBCT-MRI combined study.
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Lyu Xingyu, Bi Ruiye, Shi Yuke, Zhao Jiannan, Kang Jia, Li Xiaoqing, Han Xianglong, Ren Mingjun, Wang Yiru, Bassam Abotaleb, Zhu Songsong, Cao Pinyin
Аннотация
OBJECTIVE: This study aims to classify the morphology and position of the temporomandibular joint disc in patients with disc displacement with reduction (ADDWR) on MRI and explore their correlation with temporomandibular joint osteoarthritis(TMJOA), in order to identify ADDWR patients with a higher prevalence of TMJOA.
METHODS AND MATERIALS: This cross-sectional study consecutively enrolled 1577 patients with ADDWR at West China Stomatological Hospital, Sichuan University, from December 2022 to March 2026, with all imaging data prospectively collected according to a predefined protocol. The morphology and position of the TMJ disc were classified using oblique sagittal MRI images in both the opened and closed mouth positions. Among these, 502 patients with complete MRI and CBCT data were included in the cross-sectional association analysis of TMJOA using binary logistic regression.
RESULTS: Based on oblique sagittal MRI images taken with the mouth closed, disc morphology was classified into five types: biconcave, angulated, elongated, short and thick, and anterior thickened; disc position was classified as complete anterior displacement or partial anterior displacement according to the location of the posterior margin of the disc's posterior band relative to the tip of the condyle. MRI images taken with the mouth open classified disc morphology into biconcave and elongated types, and disc position into normal position, overhead, and anterior displaced. Among 502 patients (631 joints), the prevalence of TMJOA was 8.08% (51/631). Binary logistic regression analysis revealed that four closed mouth MRI features were independently associated with TMJOA. Compared with the biconcave reference group, the elongated disc (OR = 8.04, 95% CI: 3.03-21.32, P < 0.001), the short and thick disc (OR = 49.27, 95% CI: 11.56-210.03, P < 0.001), a preliminary finding based on a limited sample of 15 joints, and the anterior thickened disc (OR = 10.25, 95% CI: 2.52-41.64, P = 0.001) were each associated with a significantly increased prevalence of TMJOA. Complete anterior disc displacement in the closed mouth position (OR = 6.24, 95% CI: 2.74-14.24, P < 0.001) was also identified as an imaging feature associated with higher prevalence of TMJOA. In contrast, no opened mouth MRI features including disc morphology, disc position, or medial/lateral displacement-showed a significant association with TMJOA (all P > 0.05).
CONCLUSIONS: The morphology of the TMJ disc at the closed position (elongated, short and thick and anterior thickened disc) and complete anterior displacement are associated factors of TMJOA in patients with ADDWR.
CLINICAL RELEVANCE: Patients with ADDWR who exhibit the aforementioned closed mouth MRI features may benefit from increased clinical awareness and further evaluation to address the potential risk of TMJOA‑related bone changes.
METHODS AND MATERIALS: This cross-sectional study consecutively enrolled 1577 patients with ADDWR at West China Stomatological Hospital, Sichuan University, from December 2022 to March 2026, with all imaging data prospectively collected according to a predefined protocol. The morphology and position of the TMJ disc were classified using oblique sagittal MRI images in both the opened and closed mouth positions. Among these, 502 patients with complete MRI and CBCT data were included in the cross-sectional association analysis of TMJOA using binary logistic regression.
RESULTS: Based on oblique sagittal MRI images taken with the mouth closed, disc morphology was classified into five types: biconcave, angulated, elongated, short and thick, and anterior thickened; disc position was classified as complete anterior displacement or partial anterior displacement according to the location of the posterior margin of the disc's posterior band relative to the tip of the condyle. MRI images taken with the mouth open classified disc morphology into biconcave and elongated types, and disc position into normal position, overhead, and anterior displaced. Among 502 patients (631 joints), the prevalence of TMJOA was 8.08% (51/631). Binary logistic regression analysis revealed that four closed mouth MRI features were independently associated with TMJOA. Compared with the biconcave reference group, the elongated disc (OR = 8.04, 95% CI: 3.03-21.32, P < 0.001), the short and thick disc (OR = 49.27, 95% CI: 11.56-210.03, P < 0.001), a preliminary finding based on a limited sample of 15 joints, and the anterior thickened disc (OR = 10.25, 95% CI: 2.52-41.64, P = 0.001) were each associated with a significantly increased prevalence of TMJOA. Complete anterior disc displacement in the closed mouth position (OR = 6.24, 95% CI: 2.74-14.24, P < 0.001) was also identified as an imaging feature associated with higher prevalence of TMJOA. In contrast, no opened mouth MRI features including disc morphology, disc position, or medial/lateral displacement-showed a significant association with TMJOA (all P > 0.05).
CONCLUSIONS: The morphology of the TMJ disc at the closed position (elongated, short and thick and anterior thickened disc) and complete anterior displacement are associated factors of TMJOA in patients with ADDWR.
CLINICAL RELEVANCE: Patients with ADDWR who exhibit the aforementioned closed mouth MRI features may benefit from increased clinical awareness and further evaluation to address the potential risk of TMJOA‑related bone changes.