Effect of sagittal position of the articular disc on condylar bone remodeling after disc repositioning surgeries in adolescents: A retrospective cohort study.

The effect of postoperative position of the articular disc on condylar bone remodeling in adolescents with anterior disc displacement without reduction (ADDwoR) remains unclear. This study aimed to evaluate the effect of sagittal position of disc on condylar morphology and clinical outcomes. 51 adolescents (81 joints) were included. Patients were divided into three groups (group A, B, C form anterior to posterior) based on the sagittal position of disc as shown by postoperative MRI. Clinical outcomes (improvement in pain levels, maximum incisal opening, and abnormal mouth opening) and both quantitative (measurements of condyle based on three-dimensional evaluation) and qualitative (bone remodeling areas of condyle based on two-dimensional evaluation) variables in CBCT were analyzed across groups. The results showed that the different sagittal positions of the disc after surgery significantly affect condylar bone remodeling 6 months postoperatively in adolescents with ADDwoR. Broader areas of bone formation were observed in Groups B and A compared to Group C, resulting in a less uniform condylar shape. As the repositioned disc shifted posteriorly, the bone remodeling area on the condyle correspondingly moved posteriorly. Surgical strategies should prioritize appropriate disc positioning to optimize bone regeneration and reduce postoperative degeneration.