Efficacy of two different treatment modalities for juvenile patients with anterior disk displacement without reduction: an 18-month follow-up study.

This study aimed to investigate the prognosis of adolescent patients with anterior disk displacement without reduction (ADDwoR) who were treated with disk repositioning through suturing or arthrocentesis plus hyaluronic acid (HA) combined with stabilization splint (SS). A total of 96 ADDwoR patients aged ranging from 12 to 18 years, were divided into two groups, including 52 patients in Group A (underwent disk repositioning by suturing) and 44 patients in Group B (underwent arthrocentesis plus HA combined with SS). Condylar height, disk length, maximum mouth opening (MMO), maximal protrusive movement (PM), left/right maximal lateral movement (LLM/RLM) and visual analogue scale (VAS) pain scores were comparatively analyzed between the two groups before and after treatment. Baselined data analysis showed there was no statistical significance in condylar height, disk length, MMO, PM, LLM, RLM, and VAS values between two groups preoperatively. Postoperatively, values of condylar height and disk length in Group A were larger than those in Group B (all P < 0.001); whereas PM, LLM, and RLM values of Group B were all significantly larger than those of Group A (all P < 0.001). However, no statistical difference was obtained in MMO and VAS score between two groups after treatment (all P > 0.05). Both two surgical techniques can effectively relieve pain and improve MMO of adolescent patients with ADDwoR. The maximal protrusive and lateral movement of Group B were superior to those of Group A, while the latter can effectively enhance condylar development and prevent mandibular deformities.