Evaluation of temporomandibular joint changes seen in pre-operative and post-operative patients of oral submucous fibrosis using MRI: A prospective study

Abstract

To evaluate alterations in temporomandibular joint due to immobilisation and re-mobilisation in oral submucous fibrosis patients. The study population included 2 groups, patients and normal – 22 TMJ’s of 11 individuals respectively. MRI was performed on all patients pre-operatively and 5 month post-operatively and also on controls. Disc thickness (anterior, intermediate and posterior zone), disc length, joint space and structural changes in the glenoid fossa and condylar head were assessed in all the MRI scans. The severity of changes in relation to duration of reduced mouth opening was noted. And, finally regeneration potential of the TMJ after remobilizing the jaw, on 5th month POD was observed. All the measurements were tabulated and subjected to statistical analysis. The study showed that there were significant differences in the pre-op and normal. The post treatment values/dimensions were comparatively the same as that of the normal population (except for joint space on right side and disc length on left side, which is negligible). It proves that the treatment makes the condition comparably similar to that of normal dimension over a time period of 5 months, sighting the potential capacity of the TMJ to regenerate and repair. The study revealed statistically highly significant changes in the components of Temporomandibular joint in OSMF patients with varying degrees of restriction in mouth opening when compared to controls, and return of the joint structurally towards recovery at 5 month POD stresses upon the need for an early intervention.