Morphological Changes And Prognostic Evaluation Of Articular Disc Before And After Treatment In Patients With Condylar Fracture

Objective:The morphological changes of the articular disk and the clinical manifestations were compared before and after treatment in patients with condylar fracture,as well as the recovery status of the soft tissue were analyzed.This study will further increase the understanding of the changes in soft tissue before and after treatment of condylar fractures and provide a clue for the clinician in the choice of treatment methods during clinical treatment.Methods:1.A total of 20 condylar fracture patients from the Second Hospital of Shanxi Medical University during October 2015 to February 2018,complying with the inclusion criteria(based on physical examination and CT and 3D reconstruction of the upper and lower jaws),were enrolled in our study.Opening mouth degree,opening mouth shape,and occlusal relationships were tested before treatment.Bilateral temporomandibular joint of all patients were examined by magnetic resonance imaging(MRI).All patients were followed up for 6 months after treatment.Opening mouth degree,opening mouth shape,and occlusal relationships were tested,bilateral temporomandibular joint were examined by MRI.2.To compare the clinical symptoms and images of MRI before and after treatment,analyze the changes of morphology and the location of articular disk,the effusion of articular cavity and the signal of joint disk in MRI.To clarify the relationship between the clinical manifestations of the condylar fracture and the changes of the soft tissues of the articular disk after treatment,and to guide clinical treatment of condylar fractures.Results:1.All 20 patients had opening limitation and occlusive disorder in varying degrees at the first time to see the doctor;there were different morphologic and position changes of the soft tissue in the MRI image.2.When 20 patients further consulted with the doctor after six months,all patients recovered their original mouth opening degree,opening mouth shape and occlusal relationship.The image of MRI showed that all patients were located in the articular disc fossa.Among of these patients,8 of them showed the biconcave shape of the articular disc morphology,the others improved comparing with before treatment.The edema of the articular disc subsided,and the effusion were absorbed.The image signals of MRI were changed from abnormal signals to normal signals.Conclusion:1.After treatment,the position of joint disc is located in the glenoid fossa.2.The temporomandibular joint disc showed different form in the image of MRI including elongation(thinning),thickening of posterior band,flexion and full deformation(destruction of disc completely)after simple condylar fracture.After treatment,the joint disc showed double concave,elongated and posterior thickening;the other bending deformation and complete deformation(tearing)were all healed in the image of MRI.