Dentofacial changes of non-orthodontically treated female patients with TMJ disk displacement: a longitudinal cephalometric study

Abstract

Objective: The purpose of this study was to investigate the changes in dentofacial morphology of non-orthodontically treated female patients with TMJ disk displacement. Methods: The sample consisted of 25 Korean female patients with bilateral TMJ disk displacement who visited the Department of Orthodontics, Seoul National University Dental Hospital from 1996 to 2006. Disk displacements were diagnosed using the magnetic resonance imaging (MRI) of both TMJs. Baseline (T1) and follow-up (T2) lateral cephalograms were analyzed. The mean age of samples at T1 was 18.1 +/- 3.5 years (range 14.2 - 25.8 years) and at T2, 21.1 +/- 3.5 years (range 16.2 - 28.0 years). The mean observation period was 3.0 +/- 1.9 years. Descriptive statistics for each variable were calculated at baseline (Ti) and follow-up (T2) stages, and during the observation period (12-T1). Results: Skeletal changes were found in 64% of the non-orthodontically treated female patients with TMJ disk displacement during the observation period. The L1 to Mandibular plane distance (mm) increased significantly by 0.8 mm (p < 0.01). But there were no significant differences in the other dental relationship variables (overjet, overbite, U1 to palatal plane) during the observation period. Most patients with skeletal changes showed a backward rotation of the mandible. The ratio of the rotation was a decrease of SNB by 0.43 degrees for every 1 degrees increase of FMA (Spearman rho = -0.660, p < 0.01). A few patients showed a distal shift of the mandible without rotation or significant changes in the vertical dimension. Conclusions: During observation periods without orthodontic treatment, non-growing patients with TMJ disk displacement showed dentoskeletal changes, mainly backward rotation of the mandible. (Korean J Orthod 2010;40(6):398-410)