Distinguishing Between Acute and Chronic Temporomandibular Disorder in Adolescent Patients

This study compared the clinical and imaging characteristics of chronic temporomandibular disorder (TMD) to those of acute TMD in adolescent patients to identify factors contributing to symptom chronicity in adolescent patients with TMD. The 158 participants were divided into the acute (symptom duration < 6 months) and chronic (symptom duration ≥ 6 months) TMD groups. Clinical reports, panoramic radiographs, and magnetic resonance images (MRIs) of the temporomandibular joint were retrospectively reviewed and compared between groups. The results showed that the overall women-to-men ratio among adolescent patients with TMD was 1.87:1 and did not differ significantly between the groups. Moreover, compared with the acute group, the chronic group showed a significantly longer treatment duration; significantly smaller anterior and posterior joint spaces; significantly greater nasomaxillary (Na-Mx) midline discrepancy; significantly more prevalent anterior disc displacement (ADD); and higher rates of bruxism, poor posture, sleep problems, headache, and irregular diet. Treatment duration ≥ 1 year was most strongly associated with chronic TMD, followed by anterior joint space narrowing, ADD on MRI, Na-Mx discrepancy, and bruxism. Therefore, as symptom chronicity progresses, treatment duration tends to increase, and patients are more likely to experience structural changes. Clinicians should consider these findings in diagnosis and treatment of adolescents with TMD.