Mandibular Repositioning Can Be Effective in Treatment of Reducing TMJ Disk Displacement. A Long-term Clinical and MR Imaging Follow-up

ABSTRACTIn order to evaluate the long term clinical and morphologic results of recapture of a displaced TMJ disk, we recalled for follow-up MR imaging 75 patients who had been treated by attempted disk recapture based on pre-treatment MR imaging 1–6 years earlier. The treatment included a day appliance with inclines to guide the mandible into the therapeutic position and a telescopic night appliance which prevented retrusion of the mandible during sleep. Appliance treatment was followed by rebuilding or resurfacing the posterior teeth of one arch to permanently support the mandible in the therapeutic position. After treatment of 115 joints with displaced disks, 52% of the disks were normally positioned, 23% were improved in position, and 25% showed persistent disk displacement. Symptom relief was 92% in patients with normalized (recaptured) disks, 84% in patients with improved disk position, and 49% in patients with persistent disk displacement. Failure to improve disk position occurred in 7% of the joint...