Prognosis and Factors Influencing Temporomandibular Joint Degenerative Disease in Adolescents: A Retrospective Study

Background Few studies have addressed the prognosis of temporomandibular joint degenerative joint disease (TMJ‐DJD) in adolescents. Objective To retrospectively analyse clinical and imaging data of adolescent patients (10–19 years) with TMJ‐DJD who had multiple follow‐up visits, focusing on condylar bone outcomes and influencing factors. Methods Clinical records and CBCT scans of adolescent TMJ‐DJD patients were reviewed. The condylar surface was divided into nine regions to assess the severity of and changes in TMJ‐DJD. Bone outcomes (improvement, no change, worsening) at different follow‐up intervals (3–6, 7–12, 13–24 months and over 24 months) were analysed for early‐ and late‐stage TMJ‐DJD. Logistic regression was employed to identify key factors affecting bone changes. Results In total, 378 patients (62 males and 316 females; 15.36 ± 2.29 years) were included. The proportions of improvement, no change and worsening were 46.8%, 35.7% and 17.5% at 3–6 months follow‐up, respectively. After over 24 months of follow‐up, these proportions shifted to 64.5%, 18.1% and 17.4%. A significantly greater proportion of early‐stage patients than that of late‐stage patients improved: 56.5% vs. 34.5% at 3–6 months and 77.4% vs. 56.5% at over 24 months, respectively ( p = 0.0167). Late‐stage DJD yielded a greater proportion of stable bone conditions. Logistic regression indicated that unilateral involvement (OR = 2.323, p = 0.005) and anterior repositioning splint (ARS) combined with manual disc reduction (OR = 2.785, p = 0.045) significantly influenced bone outcomes. Conclusion Adolescent TMJ‐DJD patients show a progressive improvement in bone outcomes. Early‐stage TMJ‐DJD exhibits more significant improvement compared to late‐stage TMJ‐DJD, which tends to remain stable. Unilateral TMJ‐DJD and ARS significantly enhance bone improvement.