Journal of Prevention and Treatment for Stomatological Diseases ›› 2017, Vol. 25 ›› Issue (6): 369-374.doi: 10.12016/j.issn.2096-1456.2017.06.006

• Cinical Study • Previous Articles     Next Articles

Disc displacement with reduction treated by modified Twin-block

Xinxin HU1(), Yaomin ZHU1(), Pei SHEN2, Xiao LUO1, Liuting HE1, Ying GU1, Chi YANG2   

  1. 1.Department of Stomatology Shenzhen Second People's Hospital The First Affiliated Hospital of Shenzhen University. Shenzhen 518000 China
    2. Department of Oral and Maxillofacial Surgery Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200000 China
  • Received:2017-01-19 Revised:2017-03-06 Online:2017-06-20 Published:2018-09-03


Objective To investigate the morphology and position changes of displaced disk with reduction after treatment by modified Twin-block. Methods 19 patients were diagnosed as displaced disk with reduction and they were treated with modified Twin-block from July 2015 to June 2016. 28 temporomandibular joints (TMJ) of these patients were included in the analysis. The disk length, disk-condylar distance, and disk-condylar angle were measured with MRI before and after treatment. Paired t-test was used. Disk morphology before and after treatment was also documented and analyzed by Wilcoxon signed rank test. The statistical significance was set at P<0.01.Results 28 TMJ disks were anteriorly displaced with reduction. 24 of them were repositioned while the other 4 were still anteriorly positioned after treatment. The disk length was increased significantly (P<0.01) while the disk-condylar distance and disk-condylar angle were decreased significantly after treatment (P<0.01). The disk morphology as hemiconvex (16) and bi planar (9) were the majority before treatment, while biconcave (16) and biplanar (10) were changed to the larger part after treatment. There was improvement on the disk deformation with a statistical significance (P<0.01). Larger disk-condylar distance, disk-condylar angle and severer deformation of disks were observed in the 4 disks without reposition.Conclusion Modified twin-block is an effective appliance for disk displacement with reduction by repositioning the disk and modifying the disk deformation. However the effect is not good for disks with severer deformation and displacement. Further studies with larger sample and stratified group are still needed.

Key words: Anterior disc displacement with reduction, Modified Twin-block, Magnetic resonance imaging, Disk position, Disk morphology

CLC Number: 

  • R782.05

Figure 1

MRI changes before and after modified Twin-block treatment"

Figure 2

Measurements of disk length, disk-condylar distance, and disk-condylar angle"

Figure 3

Disk configuration"

Table 1

Disk length, disk-condylar distance, and disk-condylar angle before and after treatment (n = 28)"

关节盘长度 (mm) 盘髁距离 (mm) 盘髁角度 (°)
治疗前 10.51 ± 1.33 3.89 ± 0.90 29.18 ± 9.31
治疗后 11.10 ± 1.40 0.95 ± 1.85 6.67 ± 12.28
t -3.56 8.91 9.45
P 0.0014 <0.001 <0.001

Table 2

Disk configuration before and after treatment (n = 28)"

双凹形 双面平滑形 V形 双凸形 折叠形 W P
治疗前 2 9 16 1 0 656.6 <0.001
治疗后 16 10 1 1 0
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