Promotion of condylar remodeling following disc repositioning surgery for adolescent non-reducing temporomandibular joint disc displacement.

This retrospective case series aimed to evaluate clinical and MRI-based changes after temporomandibular joint (TMJ) disc anchorage surgery in adolescents with anterior disc displacement without reduction and condylar resorption, and to explore factors associated with postoperative condylar remodeling. Seventy adolescent patients (11-20 years old) diagnosed with anterior disc displacement without reduction were treated with temporomandibular joint disc anchorage followed by occlusal splint therapy. All 70 patients completed the 6-month postoperative follow-up, while 65 patients reached the 12-month follow-up; the remaining 5 patients had not yet reached the 12-month postoperative time point. Clinical and MRI assessments included maximum mouth opening (MMO), visual analog scale (VAS), Helkimo index, disc length (DL), condylar height (CH), bone marrow edema (BME), and occlusal classification. At 6 months, MMO, DL, and CH increased significantly, while VAS and Helkimo index decreased significantly. In the 12-month subgroup, clinical improvement and DL were maintained, and CH continued to increase significantly. Univariable GEE analyses indicated that bruxism, unilateral mastication, and BME were associated with increased odds of non-remodeling at 6 months, whereas splint wear was associated with reduced odds. At 12 months, only three sides showed decreased CH; therefore, associations with potential factors were evaluated descriptively because of the sparse number of events. Open TMJ disc anchorage with postoperative splint therapy was associated with symptom improvement, stable disc repositioning, and favorable MRI-based condylar remodeling. However, causal inference and treatment superiority cannot be established due to the retrospective design, absence of control groups, and limited 12-month follow-up.