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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 1999 October;48(10):447-62
Changes in disc morphology and position after non-surgical therapy: MNR findings and clinical correlations
Desiate A., Milano V.
Aims. To evaluate the position and shape of the disc using MNR before and after non-surgical therapy and to correlate MNR findings with other signs and symptoms.
Methods. MNR imaging of 26 joints belonging to a selected sample of 13 patients (7 F, 6 M, mean age 27 years) with signs and symptoms were compared with MNR performed after a period of non-surgical treatment that included a combination of splint therapy, psychoeducational advice, drugs and physiotherapeutic aids, including manipulation. The criteria for selection were monolateral symptoms and bilateral nature at the initial NMR showing reducible and non-reducible dislocation not associated with degenerative changes and/or effusion. The interval between diagnostic NMR and control imaging was approximately 12 months. The interval between splint application and control NMR was approximately 8 months. NMR included a sagittal study with the mouth open and shut and a coronal study only with the mouth shut using 3 mm-wide cuts. Post-therapy RMN was performed without the splint in position.
Results. The comparison between NMR images showed that 17 of the 26 joints studied had a stationary pathological situation and 9 were in evolution. In spite of these pathological NMR images, the signs and symptoms were found to have regressed or improved.
Conclusions. These findings can be interpreted in two ways: the disc dislocation and deformation are compatible with the lack of signs and symptoms, or many dislocations should be regarded as an anatomical variation rather than an abnormality.