Frankel appliance therapy and the temporomandibular disc: A prospective magnetic resonance imaging study

This prospective clinical study assessed the effect of the Frankel Functional Regulator-II (FR-II) treatment on the position and shape of the articular disc of the temporomandibular joint. the sample included magnetic resonance images of 112 temporomandibular joints taken initially (T1) and after 18 +/- 1 months (T2). the subjects were 56 white Brazilian children who were beginning their pubertal growth spurt. They had Class 11 Division 1 malocclusions and were selected from 800 children in neighborhood schools. They were randomly dichotomized into either the treated group (treated with the FR-II for 18 months) or the control group (not treated during the observation period). Our findings showed a low prevalence (3.57%) of disc displacement in the 112 temporomanclibular joints. Mandibular propulsion with the FR-II had no unfavorable effect on the temporomandibular joints of the treated group; 100% of the patients kept an upper and interposed disc position (closed and open mouth, respectively) at T1 and T2. the control group had 7.1% partial anterior media[ disc displacement, both at T1 and T2. Regarding disc morphology, the control group showed biconcave-shaped discs in 82.1% of the joints, statistically similar to the treated group (89.3%) at the beginning of the observation period. At T2, the articular disc morphology of the control group was unchanged, but that of the treated group was significantly more normal (P = .016), progressing from nonbiconcave at T1 (10.7%) to biconcave at T2 (100%). Our results showed that disc displacement is not a complication of functional appliance therapy; in fact, such treatment might help some children with incipient temporomandibular disorders.Univ N Carolina, Sch Dent, Dept Orthodont, Chapel Hill, NC 27599 USAUniversidade Federal de São Paulo, Paulista Sch Med, Dept Diagnost Imaging, São Paulo, BrazilUniv N Carolina, Dent Res Ctr, Chapel Hill, NC 27599 USAMethodist Univ São Paulo, Dept Orthodont, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Dept Diagnost Imaging, São Paulo, BrazilWeb of Scienc