Three-dimensional evaluation of articular disc position and other temporomandibular joint morphology among Chinese patients with temporomandibular disorders: A retrospective MRI study

Three-dimensional evaluation of articular disc position and other temporomandibular joint morphology among Chinese patients with temporomandibular disorders: A retrospective MRI study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Three-dimensional evaluation of articular disc position and other temporomandibular joint morphology among Chinese patients with temporomandibular disorders: A retrospective MRI study ALMUSTAFA OSAMA, Mazen Musa, Cheng Dong zheng, Hai Juan Zhang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5327858/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The etiology and pathophysiology of temporomandibular disorders (TMDs), particularly the internal derangement of the joint, remain unclear. Accordingly, this study aimed to investigate the discal space changes, condylar position, and distance of disc displacement that occur in patients with temporomandibular disorder (TMD) and to explore joint space dimensions correlation to other factors such as age, sex, and distance of disc displacement. Methods A total of 130 patients (260 joints) were included in this cross-sectional study. The magnetic resonance imaging (MRI) of each patient was used to evaluate the temporomandibular joint (TMJ) discal space dimensions in the coronal and sagittal sections, and the distance of disc displacement. One-way ANOVA and Independent sample t-test were used for the normally distributed variables, and Kruskal-Wallis, Mann-Whitney u test were used for non-normally distributed variables. Bivariate correlation was conducted using spearman correlation coefficients to investigate the relation between age, disc position, and joint space dimensions. Results Among the sagittal spaces, the central joint space (CJS) was significantly larger on both sides (p < 0.001). When comparing joint spaces among sexes, the right side anterior joint space (AJS) was significantly greater in females (p = 0.006), while the left side medial and lateral joint spaces (MJS and LJS) were greater in males (p = 0.037 and 0.026, respectively). Discal space dimensions showed to be narrower in patients younger than 25 years, particularly for the central and medial discal spaces (p = < 0.001). The results of the bivariate analysis revealed a significant moderate to weak positive correlation between the age, AJS, CJS, and MJS in anterior disc displacement with reduction ADDWR (𝑟-2. = 0.408, 0.537, 0,287, respectively). Likewise, correlation between age and MJS showed weak correlation in anterior disc displacement without reduction ADDWoR (𝑟-2. = -0.253). Conclusion The central joint space is the largest among the other spaces. There are significant differences in joint space dimensions between sexes and age groups. Females have larger anterior joint spaces, whereas males present larger medial and lateral joint spaces. Additionally, younger individuals present narrower discal spaces, with age correlating moderately to weakly with joint space dimensions in cases of anterior disc displacement. Magnetic resonance imaging Temporomandibular disorders Temporomandibular joint Internal derangement Articular disc Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 1. Background The temporomandibular joint (TMJ) is a part of the craniofacial complex and one of the most complex synovial joints in the body. The most orthopedically stable TMJ position is when the condyles are in their most superoanterior position in the articular fossae, resting against the posterior slopes of the articular eminences, with the articular discs properly interposed, any changes in this position could be a factor in the development of temporomandibular disorders[ 1 ]. Temporomandibular disorders (TMDs) are a subgroup of craniofacial pain problems that involve the TMJ, masticatory muscles, and associated head and neck musculoskeletal structures [ 2 ]. Anterior disc displacement (ADD) is one of the most common subtypes of TMDs, and can be further divided into anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR), with the latter having more severe symptoms and greater difficulty in treatment. Other types of disc displacement but less common are posterior disc displacement (PDD), lateral disc displacement (LDD), and medial disc displacement (MDD) [ 3 ]. Pain, limited or asymmetrical mandibular motion, and TMJ sounds are the most frequent symptoms associated with TMDs[ 4 , 5 ]. The pain or discomfort is often localized to the jaw, TMJ, and muscles of mastication. Frequently associated symptoms may include ear pain, tinnitus, dizziness, neck pain, and headaches. Some individuals may experience a sudden onset with mild and self-limiting. However, in other cases, a chronic temporomandibular disorder may manifest, leading to ongoing pain and a range of physical, behavioral, psychological, and social symptoms resembling those seen in individuals with chronic pain disorders affecting other parts of the body (e.g., arthritis, back pain, headaches, and muscle strains)[ 6 – 8 ]. The application of noninvasive imaging methods, such as magnetic resonance imaging (MRI), has significantly increased in the reported prevalence of TMJ disc disorders. In asymptomatic adult populations, the rates have increased from 30–75%, and in symptomatic groups, they have increased from 12–82%, and according to MRI findings, the prevalence of TMJ disc displacement is approximately 50% among preorthodontic adolescent boys and 75% among preorthodontic adolescent girls [ 9 ] Several studies have evaluated the association between TMJ disc status and craniofacial characteristics; in general, these studies have indicated that internal derangement of the TMJ is associated with several changes, including a decrease in ramus height, a shortened length of the mandibular body, and a diminished total posterior facial height. Additionally, the palatal and mandibular planes exhibit greater convergence in the posterior area, the vertical position of the maxillary molars is reduced, the sizes of both the anterior and posterior cranial bases are smaller, and the mandibular incisors are positioned more upright in relation to the mandibular plane [ 9 ]. The etiology and pathophysiology of TMDs, particularly internal derangement of the joint, remain unclear. Understanding the natural progression of disc displacement is crucial for developing an effective treatments for this condition [ 10 ]. Previous studies have not shown a clear link between joint space changes, condylar position, and degree of disc displacement in patients with TMD. Our objective in this study is to thoroughly investigate the discal space changes, condylar position, and distance of disc displacement that occur in patients with TMD. Furthermore, we correlated these changes with other factors such as age, sex, and degree of disc displacement. 2. Materials and Methods 2.1 Study population: This retrospective study was ethically approved by the Stomatological Hospital of Xi’an Jiaotong University Medical Ethics Committee under the ethical approval number: 2024-XJKQIEC-KY-QT-0035-002. From 2020–2024, the medical records of patients who were referred to the orthodontics department and were diagnosed with TMD were examined. Informed consent was obtained from all subjects. The inclusion criteria were as follows: (1) patients who underwent MRI and CBCT scans for the purpose of diagnosing of TMDs with no restriction to a specific age; (2) had been diagnosed according to the DC/TMD Axis I [ 11 ]; and (3) had no previous orthodontic treatment. The exclusion criteria were as follows: (1) patients with previous TMJ surgeries or systematic diseases that would cause changes in the structure or physiology of TMJ or surrounding structures (e.g., rheumatoid arthritis, idiopathic juvenile arthritis, systematic lupus erythematosus, or osteoporosis); (2) patients with head and neck neoplasms and tumors; (3) patients with a history of congenital or developmental disorders(e.g. unilateral condylar hypoplasia or hyperplasia ) (4) patients with history of drugs that affect bone metabolism(e.g. calcitonin, bisphosphonate, and hormones), and (5) patient’s with poor MRI or CBCT image quality. Moreover, CBCT scans were evaluated to assess the presence of any type of osseous pathology of the TMJ, and any patient with marked osseous destruction was excluded. 2.1.1 Sample size calculation: The minimum sample size was determined via GPower (Version 3.1.9.4) software, with α set at 0.05, a power of (1 − β) at 0.8, and an effect size (f) of 0.3. The calculated minimum total sample size was 190 joints, which is less than the number of joints examined in the study. This study included 276 joints from 138 patients; however, 8 patients were excluded due to the poor MRI or CBCT image quality, thus the final sample studied sample was 130 patients (260 joints). 2.2 MRI protocol: MRI scans were obtained using the United Imaging 3.0T MR scanner (uMR870) (United Imaging Healthcare, China). Proton density (PD) fast spin echo (FSE). MRI sequence in the closed mouth position (TR/TE; 2420/49.14; 8 slices; 2 mm slice thickness for both sagittal and coronal views; 100 mm FOV). The teeth were held in a maximum intercuspal position with the mouth closed, whereas each patient's maximum voluntary mouth opening was needed when their mouth was open during the MRI scanning of the open mouth position. All measurements and evaluations on both sagittal and coronal views were performed in the closed-mouth position because measurements in open-mouth position are not stable in TMD patients, the discrepancies in condyles, disc displacements, and limitation of mouth opening in some patients, all these are factors that may affect the measurements on open-mouth position views. However, the open-mouth position was used to differentiate between ADDWR and ADDWoR. 2.3 Image analysis: All image analyses and measurements were conducted via RadiAnt DICOM Viewer (Medixant, Poznań, Poland). The sagittal slice showing the most significant deformation and displacement of the TMJ discs in the closed mouth position was selected for assessment. The patients' MRIs were reviewed, and all measurements and analyses were conducted by two investigators who received training from an experienced oral and maxillofacial radiologist. The intra-class correlation coefficient (ICC) was used to assess the inter- and intra-examiner reliability; Crombach’s alpha was > 0.8, which indicates excellent reliability. 2.3.1 Joint space assessment: The measurement and analysis of each MRI image were performed in two views (sagittal and coronal) in closed mouth position. In the sagittal view, as shown in (Fig. 1 , a and b ), three sites were measured, the anterior joint space AJS, central joint space CJS, and posterior joint space PJS. In this image, we drew a line parallel to the true horizontal line, passing through the deepest point at the condylar fossa, from this line, another perpendicular line was connected to the most superior point on the condyle to record the CJS. From the horizontal line, we dragged down 2 lines to touch the most anterior and posterior points on the condylar head as shown in the figure, and connected them to the most anterior and posterior points at the fossa to record the AJS and PJS, respectively. In the coronal view, two spaces were measured: the medial joint space (MJS) and the lateral joint space (LJS). Measurements were performed by drawing two lines from the middle of the mandibular fossa and dragging it obliquely to touch the medial pole and lateral pole, and then drawing another two perpendicular lines to measure the medial and lateral spaces, as shown in (Fig. 2 ) . The condylar concentricity values were determined after the AJS and PJS were measured. We used the formula JSI= [(P – A) ÷ (P × A)] ×100, where the JSI is the joint space index A is the anterior joint space and P is the posterior joint space. The positive values indicate an anteriorly positioned condyles in respect to the condylar eminence, while the negative values indicate a posteriorly positioned condyles. 2.3.2 Determination of Disc Displacement: The disc position was evaluated in the closed-mouth position. The ADD was defined as the most posterior edge of the articular disc being located anterior to the 12:00 position relative to the long axis of the condyle. Conversely, the PDD is determined when the posterior edge of the disc is posterior to the 12:30 position. Otherwise, the disc was determined to be normally positioned (Fig. 3 ). A diagnosis of ADDWR and ADDWoR was made based on the open-mouth position MRI. Cases were classified as ADDWR when the intermediate zone of the disc was positioned between the condylar articular surface and the articular eminence. Conversely, cases were classified as ADDWoR. LDD and MDD were assessed via coronal imaging. A reference line was created along the long axis of the condylar pole and its neck (Fig. 4 ). Additionally, another line was drawn across the widest part of the condylar pole and divided into 10 equal segments. The position of the disc was noted in relation to these 1/10 divisions of the condylar width. Negative measurements indicated LDD, whereas positive measurements indicated MDD, with a value of 0 mm representing the normal position. The distance of disc displacement as shown in (Fig. 5 ) , was determined by initially drawing the long-axis of the condyle (A-B) using the two-step method that was described by Nebbe et al. and Xie et al.[ 11 , 12 ]. Two points were subsequently identified, point C was the intersection point between the long axis of the condyle and the contour of the condylar bone cortex, and point D is the most posterior point of the disc. The C-D distance was defined as the distance of disc displacement. 2.4 Statistical analysis: The Statistical Package for Social Sciences (SPSS) version 27.0 (IBM Corporation, Chicago, Ill) was used for statistical analyses. Twenty-five randomly selected MRI images were chosen, and the measurements were repeated by two investigators two weeks after the first measurement; the intra-class correlation coefficient (ICC) was used to assess the inter- and intra-examiner reliability. For the descriptive statistics, means and standard deviations were calculated. The Shapiro-Wilk test was performed to assess the distribution of the data; One-way ANOVA and Independent sample t-test used for the normally distributed variables; Kruskal-Wallis and Mann-Whitney u test used for non-normally distributed variables. Bivariate correlation was conducted using spearman correlation coefficients to investigate the relationship among age, disc position, and joint space dimensions. 3. Results 3.1. Demographic characteristics: A total of 130 patients (260 joints) with a mean age of 24.7 ± 10.4 years were included in the present study. Among these patients, 34 (mean age 23.8 ± 11.3) were male, and 96 (mean age 25 ± 10.2) were female. There were 84 (32.3%) normal discs, 72 (27.6%) discs with ADDWR, 65 discs (25.3%) discs with ADDWoR, 24 (9.2%) with MDD,13 (5%) with LDD and 1 disc with Posterior displacement (PDD). 3.2. Joint spaces and disc position: MRI readings of the right side were not significantly different from those on the left side (p > 0.05). On the right side of the sagittal view, the mean anterior joint space (AJS), central joint space (CJS) and posterior joint space (PJS) were 2.81 mm (SD ± 0.66 mm), 3.24 mm (SD ± 0.7 mm), and 2.91 mm (SD ± 0.52 mm), respectively. Similarly, on the left side, the mean values were, AJS 2.93 mm (SD ± 0.7), CJS 3.34 mm (SD ± 0.74 mm), and PJS 2.95 mm (SD ± 0.5 mm). The mean value for condylar concentricity was 2.24% (SD ± 12.7) on the right side and 0.96% (SD 13.5±) on the left side. Among the sagittal spaces the CJS was significantly the larger on both sides (p < 0.001). On the right side of the coronal view, the mean values of the medial joint space (MJS) and lateral joint space (LJS) were 2.68 mm (SD ± 0.63 mm) and 2.59 mm (SD ± 0.58 mm), respectively, and the ratio of MJS:LJS was 1:1.003. On the left side, MJS 2.68 mm (SD ± 0.66 mm), LJS 2.76 mm (SD ± 0.59 mm), and the ratio of MJS:LJS is 1:1.07. Among the coronal spaces no significant difference was found (p > 0.05) ( Table 1 , Figs. 6 and 7 ). Table 1 The mean and standard deviation of MRI readings of the sagittal and coronal view of the left and right TMJ. N Mean SD Anterior JS 130 2.81 ± 0.66 Right Central JS 130 3.24 ± 0.7 Sagittal Posterior JS 130 2.91 ± 0.52 Anterior JS 130 2.93 ± 0.7 Left Central JS 130 3.34 ± 0.74 Posterior JS 130 2.95 ± 0.5 Medial JS 130 2.68 ± 0.63 Right Coronal Lateral JS 130 2.59 ± 0.58 Medial JS 130 2.68 ± 0.66 Left Lateral JS 130 2.76 ± 0.59 When comparing joint spaces among sexes the right side AJS was significantly greater in females (2.9 mm) than in males (2.57 mm) (P = 0.006), whereas the left side MJS was greater in males (3.04 mm) than in females (2.55 mm) (P = 0.037). Furthermore, the left LJS was significantly greater in males (2.8 mm) than in females (2.52 mm) (P = 0.026) ( Table 2 , Figs. 8 and 9 ). Table 2 Comparison of MRI readings of sagittal and coronal views of the left and right TMJ between males and females. Gender N Mean(mm) SD P value AJS Male 34 2.57 0.1 0.006* Female 96 2.9 0.06 Right CJS Male 34 3.26 0.10 0.711 Female 96 3.24 0.07 Sagittal PJS Male 34 2.9 0.09 0.998 Female 96 2.91 0.05 AJS Male 34 2.75 0.1 0.085 Female 96 2.99 0.07 Left CJS Male 34 3.41 0.11 0.523 Female 96 3.32 0.07 PJS Male 34 2.98 0.07 0.313 Female 96 2.94 0.05 MJS Male 34 2.87 0.11 0.156 Female 96 2.61 0.06 Right LJS Male 34 2.8 0.1 < 0.001*** Female 96 2.52 0.05 Coronal MJS Male 34 3.04 0.12 0.026* Female 96 2.55 0.06 Left LJS Male 34 2.87 0.1 0.037* Female 96 2.72 0.06 Note: ***: p < 0.001, **: p < .0.01, *: p 0.001); furthermore, among the spaces in the coronal view, the right MJS values were significantly lower in patients younger than 25 years patients (2.46 mm ± 0.58, p < 0.001). (Table 3 ) Table 3 Comparison of the MRI readings of the sagittal and coronal views of the left and right TMJ between different age groups. Age Group N Mean (mm) SD P value AJS Less than 25 79 2.73 0.58 0.739 25–34 32 2.95 0.74 35–44 11 2.9 0.95 45 and above 8 2.86 0.62 Right CJS Less than 25 79 3.06 0.68 0.000** 25–34 32 3.63 0.71 35–44 11 3.28 0.32 45 and above 8 3.46 0.61 PJS Less than 25 79 2.9 0.5 0.71 25–34 32 3 0.6 Sagittal 35–44 11 2.85 0.52 45 and above 8 2.74 0.46 AJS Less than 25 79 2.87 0.65 0.756 25–34 32 3.01 0.68 35–44 11 3.1 1.1 45 and above 8 2.9 0.72 Left CJS Less than 25 79 3.13 0.66 0.000** 25–34 32 3.8 0.74 35–44 11 3.5 0.52 45 and above 8 3.41 0.9 PJS Less than 25 79 2.92 0.51 0.508 25–34 32 3.04 0.52 35–44 11 3.01 0.31 45 and above 8 2.81 0.5 Note: ***: p < 0.001, **: p < .0.01, *: p < 0.05. The mean of disc positions in the joints with normal discs, ADDWR and ADDWoR were (-1.16mm ± 1.46), (2.9mm ± 0.78) and (5.25mm ± 1.8) respectively. 3.3. Disc displacement: After the joints were divided into five groups according to the disc displacement diagnosis, a comprehensive analysis was performed to analyze all the variables among the different joints ( Table 4 A ) . In normal discs, the AJS was significantly narrower among the sagittal spaces (2.74 mm ± 0.55, p = < 0.001), whereas the LJS was significantly narrower among the coronal spaces (2.61 mm ± 0.69, p = 0.024). On the other hand, in patients with ADDWR, the AJS presented significantly greater values (3.08 mm ± 0.81, p = 0.04). In joints with ADDWoR the spaces were not significantly different. Moreover, among the discs with MDD the MJS was significantly greater (3.14 mm ± 0.5, p = < 0.001). In contrast, the LDD was greater for the LJS (3 mm ± 0.76, p = < 0.001). Table 4 B shows the results when comparing joint spaces between normal joints, ADDWR, ADDWoR, MDD, and LDD. The condylar concentricity in the ADDWR was − 2.94 (± 10.9) while in ADDWoR was − 1.3(± 14.7), which indicates posteriorly positioned condyles. (Table 4 A ) Table 4 Comparison of the MRI readings of the coronal view of the left and right TMJ Age Group N Mean (mm) SD P value MJS Less than 25 79 2.52 0.58 0.002* 25–34 32 2.92 0.57 Right 35–44 11 2.98 0.73 45 and above 8 2.88 0.85 LJS Less than 25 79 2.63 0.56 0.103 25–34 32 2.7 0.57 Coronal 35–44 11 2.25 0.58 45 and above 8 2.3 0.60 MJS Less than 25 79 2.56 0.62 0.127 25–34 32 2.89 0.66 Left 35–44 11 2.84 0.84 45 and above 8 2.71 0.73 LJS Less than 25 79 2.78 0.56 0.693 25–34 32 2.8 0.72 35–44 11 2.64 0.43 45 and above 8 2.57 0.58 between different age groups. Table 5 A: Joint space dimensions in normal disc position, ADDWR, ADDWoR, MDD and LDD. Disc displacement Joint space N Mean SD P value AJS 84 2.74 0.55 < 0.001*** Normal joints CJS 84 3.63 0.73 PJS 84 2.97 0.43 MJS 84 2.76 0.69 0.024* LJS 84 2.61 0.5 AJS 72 3.08 0.81 0.04* ADDWR CJS 72 3 0.65 PJS 72 2.8 0.47 MJS 72 2.55 0.63 0.101 LJS 72 2.72 0.77 AJS 65 3 0.7 0.68 ADDWoR CJS 65 3.2 0.68 PJS 65 3.02 0.62 MJS 65 2.61 0.61 0.156 LJS 65 2.82 0.68 AJS 24 2.4 0.47 0.003** CJS 24 2.96 0.56 MDD PJS 24 2.84 0.51 MJS 24 3.1 0.51 < 0.001** LJS 24 2.1 0.47 AJS 13 2.71 0.48 CJS 13 3.47 0.65 0.003** LDD PJS 13 2.94 0.46 MJS 13 2.31 0.36 0.001** LJS 13 3.07 0.76 Note: ***: p < 0.001, **: p < .0.01, *: p < 0.05. 3.4. Correlation results between age, degree of displacement of articular disc and joint spaces: The results of bivariate revealed a significant moderate to weak positive correlation between the age, AJS, CJS and MJS in ADDWR ( \(\:{\text{r}}^{2}\) = 0.408, 0.537, and 0,287, respectively). similarly, the correlation between age and MJS showed weak correlation ( \(\:{\text{r}}^{2}\) = -0.253). However, there was no correlation between the degree of disc displacement and the joint spaces. 4. Discussion TMD is considered to be the most prevalent orofacial pathology of non-dental origin [ 13 ]. In joints with disc displacement, the shifted position of the disc in relation to the condyle is commonly known as internal derangement. Accurate localization of the disc is essential for diagnosing internal derangement of the TMJ[ 14 ]. The present study which was based on MRI, investigated the variables of TMJ spaces, disc position, and disc displacement distance among TMD patients; furthermore, it investigated the correlation among the disc displacement, joint spaces, and age of the patients. MRI is a non-invasive imaging modality that does not use radiation and offers exceptional resolution of soft tissues. It has been recognized as the most precise method for assessing the position of the TMJ disc, thus earning it the designation of "gold standard" for this evaluation. Studies have indicated that the diagnostic accuracy of MRI for detecting disc displacement and deformity ranges from 80–90%, suggesting that MRI measurements are highly precise. The position of the TMJ disc significantly affects the growth of the craniofacial region. If the disc is improperly positioned between the condyle and the articular eminence of the glenoid fossa, it may unfavourably affect the growth and development of the maxilla and mandible[ 15 – 18 ]. Studies have reported that TMJ disc displacement is associated with a decrease in forward growth of the maxilla and mandible, as well as reduced vertical growth of the ramus[ 9 , 14 ]. Flores-Mir C et al. [ 9 ]also reported a decrease in posterior facial height with increasing anterior facial height, steep palatal and mandibular planes, vertically reduced maxillary molar position, and retroclined mandibular incisors, which are considered to be associated with TMJ disc displacement. In the present study there was a predominance of females, and this finding parallels the of a series of studies [ 10 , 19 – 23 ]. There is no clear clue about the predominance of females with TMDs, but some studies have that theorised the demand for treatment is greater among females[ 24 ]. Another study suggested that the variation is attributed to alterations in collagen metabolism linked to genetic factors causing joint laxity [ 25 ].Other studies also suggest that female sex-hormone induce pro-inflammatory cytokines, aggravating TMJ inflammation[ 26 ]. Furthermore, in the present study, the prevalence of TMD peaked in population younger than 25 years old, which accordance with many studies that reported the peak prevalence of TMD in young and middle-aged adults[ 23 , 27 – 29 ]. In the present study, the majority of the TMJ discs were in a normal position. The predominant displacement observed was the ADDWR, followed by the ADDWR. In contrast, MDD and LDD were less frequently observed, whereas PDD was nearly absent. These findings are consistent with those reported by de Farias et al.[ 10 ]. However, several other studies indicate that the prevalence of ADDWoR is greater [ 30 – 32 ]. These differences may be related to the studied sample’s characteristics[ 31 ]. In our study, joint space analysis revealed no statistically significant difference when comparing the left and right sides, and this finding agrees with many studies [ 33 , 34 ]. Displacement of the disc may lead to an alteration in the position of the condyle within the fossa, which in turn results in changes in the joint space. This alteration in the position of the condyle is influenced by both the direction and severity of disc displacement. The central joint space (CJS) was observed to be larger than the other joint spaces in the sagittal view. Whereas in the coronal MRI views, no significant differences were found between the medial and lateral joint spaces. The condylar concentricity (CC) showed decreased values, which indicates more posteriorly positioned condyles. AJS was significantly greater in the ADD than in normal discs, this finding is in line with K Ikeda’s study [ 35 ]. A Comparison joint spaces between sexes revealed that the AJS was significantly greater in females than in males, which may be attributed to the higher prevalence rate of anterior disc displacement observed in the females compared to males. Conversely, the lateral and medial joint space measurements were significantly greater in males tan females, a finding that is consistent with other studies [ 33 , 36 ]. However, this finding disagrees with the results of the study conducted by Hansson et al. [ 37 ], who reported no significant difference in the values of the joint space between the sexes. In the present study, different age groups were shown to influence the joint spaces; both CJS and MJS showed lower values in young patients younger than 25 years. In our current study, we divided the joints according to the disc position, and we studied each group separately. In normal joints, we observed that the AJS was significantly the smaller than other joint spaces in the sagittal view, whereas the MJS was significantly greater than the LJS in the coronal view. However, the AJS was significantly larger than other sagittal spaces among ADDWR joints, this finding aligns with the findings of other studies [ 14 , 35 ], and may suggest that when the disc is advanced anteriorly, it would result in morphological changes due to the remodelling processes that may take place in both the condyle and the articular eminence due to the stretch of the tissues and the inflammatory process that could take place in the displaced disc areas. However, in the ADDWoR joints there was no significant difference between the spaces; which could be due to the adaptation process that may take part in these joints as the ADDWoR reflects a more chronic situation, thus, early addressing of the ADD is crucial, and trying to treat it when it is acute and reducible is much easier before advanced changes take place. The MDD joints had significantly larger MJS and small AJS, whereas the LDD joints had significantly larger LJS and CJS. Compared with those in the ADDWR group, the TMJ discs in the ADDWoR group presented significant forward displacement. This observation indicates that as the displacement distance increased, the TMJ discs exhibited greater deformation and a tendency for ADDWoR. These findings are consistent with those of prior studies[ 3 , 38 ]; and this finding makes it easy to distinguish the ADDWoR from the closed-mouth position MRI. Our study demonstrated a correlation between age and joint spaces in both the ADDWR and the ADDWoR. In the ADDWR, AJS, CJS, and MJS exhibited a positive correlation with age. This finding suggests that the severity of disc displacement and the likelihood of progression toward ADDWoR may increase with advancing age because, in previous studies, the AJS showed to be larger with displacements. Furthermore, in the ADDWoR group, only LJS exhibited a negative correlation with age. These findings suggest that further changes in the morphology of the condyle and fossa are unlikely in ADDWoR, as significant morphological alterations have already occurred along with the chronic nature, and adaptation to the new position of the articular disc will take place, accompanied by advanced clinical features, which may include a marked limitation in mandibular opening and associated symptoms. However, the degree of disc displacement did not correlate with age or joint space in either ADDWR or ADDWoR. The primary limitation of this study is the absence of healthy TMJ subjects as a control group. Instead, we compared the group with normal disc positions with groups of different disc displacements. This may account for the slightly greater joint space values observed in the group with normal disc positions than those reported in previous studies. Another limitation is that some variables that can be related to the TMD, such as the morphology of the condyles and disc, were not measured in this study. 5. Conclusions Studying joint spaces and the position articular disc in patients with temporomandibular disorders (TMDs) is clinically important as it can aids in accurate diagnosis, inform treatment planning, monitor progress and predict outcomes. This study enhances the understanding of the underlying pathophysiology of TMD, supports the development of evidence-based practices, and encourages interdisciplinary collaboration among healthcare providers. By correlating specific disc positions and joint space measurements with treatment outcomes, clinicians can tailor personalized care and improve overall patient management in this complex area. This study revealed that the CJS was larger than others, with sex differences in measurements. AJS was larger in females, whereas MJS and LJS were larger in males. In ADDWR group, the anterior joint space was significantly larger, whereas in ADDWoR, no significant differences were found. In ADDWoR the disc position was more advanced in position than that in ADDWR. The study also demonstrated that age was correlated with joint space measurements, suggesting that greater disc displacement severity might occur with increasing age. While the degree of displacement did not correlate significantly with age or joint spaces, the results emphasize the importance of early treatment for ADD to prevent chronic adaptations and structural changes in the TMJ. Overall, these findings provide insights into the implications of disc displacement for TMD diagnosis and management. Abbreviations TMJ Temporomandibular joint TMD Temporomandibular disorder CBCT Cone beam computed tomography MRI Magnetic resonance imaging AJS Anterior joint space CJS Central joint space PJS Posterior joint space CC Condylar concentricity MJS Medial joint space LJS Lateral joint space ADDWR Anterior disc displacement with reduction ADDWOR Anterior disc displacement without reduction PDD Posterior disc displacement MDD Medial disc displacement LDD Lateral disc displacement Declarations Ethical approval and consent to participate This retrospective study was ethically approved by the Stomatological Hospital of Xi’an Jiaotong University Medical Ethics Committee under the ethical approval number: 2024-XJKQIEC-KY-QT-0035-002. All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects. Consent for publication Not applicable. Availability of data and materials The data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethical reasons. Competing interests The authors declare that they have no competing interests. Funding Not applicable. Author contributions S.W. is the correspondence of this work. Conceptualization, A.O., M.M., and C.D.; methodology, A.O. and C.D.; validation, A.O. and M.M.; formal analysis, Y.H., H.J.; investigation and radiograph measurements, A.O.; data curation, A.O.; writing—original draft preparation, M.M.; writing—review and editing, H.J., S.W.; supervision. Acknowledgements Not applicable. Authors' information ORCID AL Mustafa Osama https://orcid.org/0009-0009-0838-8701 Mazen Musa https://orcid.org/0000-0002-4545-6314 References Okeson JP. Orthodontics Current Principles and Techniques vol. 6th Edition. St. Louis, Missouri: Elsevier; 2017. Scrivani SJ, Keith DA, Kaban LB. 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Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig. 2021;25(2):441–53. Isberg A, Hägglund M, Paesani D. The effect of age and gender on the onset of symptomatic temporomandibular joint disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(3):252–7. Takatsuka S, Yoshida K, Ueki K, Marukawa K, Nakagawa K, Yamamoto E. Disc and condyle translation in patients with temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(5):614–21. Campos MI, Campos PS, Cangussu MC, Guimarães RC, Line SR. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg. 2008;37(6):529–34. Casanova-Rosado JF, Medina-Solís CE, Vallejos-Sánchez AA, Casanova-Rosado AJ, Hernández-Prado B, Avila-Burgos L. Prevalence and associated factors for temporomandibular disorders in a group of Mexican adolescents and youth adults. Clin Oral Investig. 2006;10(1):42–9. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017;37(7):692–704. Manfredini D, Guarda-Nardini L, Winocur E, Piccotti F, Ahlberg J, Lobbezoo F. Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):453–62. Cai XY, Jin JM, Yang C. Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study. J Oral Maxillofac Surg. 2011;69(11):e340–346. Sato S, Sakamoto M, Kawamura H, Motegi K. Long-term changes in clinical signs and symptoms and disc position and morphology in patients with nonreducing disc displacement in the temporomandibular joint. J Oral Maxillofac Surg. 1999;57(1):23–9. discussion 29–30. Whyte AM, McNamara D, Rosenberg I, Whyte AW. Magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement–a review of 144 cases. Int J Oral Maxillofac Surg. 2006;35(8):696–703. Alqhtani N, Alkhaldi M, Alanazi A, Alabdulsalam A, Alenazi A, Zaman M, Alzahrani A, Alshadwi A, Rafedah A, Alotaibi M. Temporomandibular Joint Space Dimensions among Saudi Patients with Temporomandibular Disorders: MRI-Based Retrospective Study. Int J Clin Pract. 2022;2022:1–9. Okur A, Ozkiris M, Kapusuz Z, Karaçavus S, Saydam L. Characteristics of articular fossa and condyle in patients with temporomandibular joint complaint. Eur Rev Med Pharmacol Sci. 2012;16(15):2131–5. Ikeda K, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofac Radiol. 2013;42(3):84227642. Kinniburgh RD, Major PW, Nebbe B, West K, Glover KE. Osseous morphology and spatial relationships of the temporomandibular joint: comparisons of normal and anterior disc positions. Angle Orthod. 2000;70(1):70–80. Hansson T, Oberg T, Carlsson GE, Kopp S. Thickness of the soft tissue layers and the articular disk in the temporomandibular joint. Acta Odontol Scand. 1977;35(2):77–83. Hu YK, Yang C, Xie QY. Changes in disc status in the reducing and nonreducing anterior disc displacement of temporomandibular joint: a longitudinal retrospective study. Sci Rep. 2016;6:34253. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5327858","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":371649155,"identity":"2db71f1d-888c-43e6-b4b3-6da39de5b7ae","order_by":0,"name":"ALMUSTAFA OSAMA","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"ALMUSTAFA","middleName":"","lastName":"OSAMA","suffix":""},{"id":371649156,"identity":"b70d4dfc-e1b1-415e-851c-0d4202895858","order_by":1,"name":"Mazen Musa","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Mazen","middleName":"","lastName":"Musa","suffix":""},{"id":371649157,"identity":"57d7fcae-fe16-4bca-b4b6-fd479df76755","order_by":2,"name":"Cheng Dong zheng","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Cheng","middleName":"Dong","lastName":"zheng","suffix":""},{"id":371649158,"identity":"51b04128-3eb8-4357-bb5e-174214294278","order_by":3,"name":"Hai Juan Zhang","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Hai","middleName":"Juan","lastName":"Zhang","suffix":""},{"id":371649159,"identity":"f934bb5f-89ad-4cf2-81d4-c0a5b79d07e9","order_by":4,"name":"Yu Han Ren","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Yu","middleName":"Han","lastName":"Ren","suffix":""},{"id":371649160,"identity":"155b5d90-4149-49ab-8260-1808f627e2bd","order_by":5,"name":"Shuang Wang","email":"data:image/png;base64,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","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":true,"prefix":"","firstName":"Shuang","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2024-10-24 18:23:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5327858/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5327858/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69429430,"identity":"25e2011f-a5ba-4cb7-a1bb-52e1a95ad91f","added_by":"auto","created_at":"2024-11-20 09:17:00","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":244555,"visible":true,"origin":"","legend":"\u003cp\u003eMeasurment of joint spaces in sagittal section. (a) true measurement on MRI (b) measurment in diagramatic sketch.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/3d25b0de5ed142354267500c.png"},{"id":69427730,"identity":"d97d9569-68d2-4dfa-bd67-f4102c052dd6","added_by":"auto","created_at":"2024-11-20 09:01:00","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":233090,"visible":true,"origin":"","legend":"\u003cp\u003eMeasurment of joint spaces in coronal section. (a) true measurement on MRI (b) measurment in diagramatic sketch.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/aab24e3e5374a7ba3626994c.png"},{"id":69428907,"identity":"d8296e2c-8694-4aff-be09-88762b2f61a1","added_by":"auto","created_at":"2024-11-20 09:09:00","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":46802,"visible":true,"origin":"","legend":"\u003cp\u003eEvaluation method for articular disc position, (A) posterior disc displacement, (B) normal disc position, (C) anterior disc displacement.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/17ceff12799cd747647983cf.png"},{"id":69428904,"identity":"7c74a3bd-527a-4e5e-aed6-387418545f7d","added_by":"auto","created_at":"2024-11-20 09:09:00","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":89302,"visible":true,"origin":"","legend":"\u003cp\u003eMethod of measuring coronal disk position.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/6da1426153decf3a5d4434b1.png"},{"id":69427725,"identity":"4c72e988-27a3-4cef-a205-5382c6c85cca","added_by":"auto","created_at":"2024-11-20 09:00:59","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":251682,"visible":true,"origin":"","legend":"\u003cp\u003eMeasurement of disc position. (a) true measurement on MRI (b) measurment in diagramatic sketch. Two circles were drawn internally tangent to the condyle. AB line passing through the center of the two circles representing the long-axis of the condyle. C point is intersection of the long axis of the condyle and the contour of the condylar cortical bone, D is the midpoint of the posterior edge of the disc, CD is the disc distance to the condyle.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/9df98388bbc0fcb7fe0497c1.png"},{"id":69427728,"identity":"a0d923d3-4c29-42af-a14f-fcde43f82fcf","added_by":"auto","created_at":"2024-11-20 09:00:59","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":17017,"visible":true,"origin":"","legend":"\u003cp\u003eThe mean distribution of MRI readings of a sagittal view of the left and right TMJ.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/bbfc83c274993b2277378752.png"},{"id":69428905,"identity":"1b8fe330-bfa4-402a-87a5-f5c8dc744639","added_by":"auto","created_at":"2024-11-20 09:09:00","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":14965,"visible":true,"origin":"","legend":"\u003cp\u003eThe mean distribution of MRI readings of a coronal view of the left and right TMJ\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"7.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/9140cdb285ce9f28610194b8.png"},{"id":69427733,"identity":"f24c1024-88cd-4158-91f6-c3a0782ceb57","added_by":"auto","created_at":"2024-11-20 09:01:00","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":17148,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of MRI readings of the sagittal view of the right TMJ between males and females.\u003c/p\u003e","description":"","filename":"8.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/dad3ad624d9f5cbcd8b5b098.png"},{"id":69427731,"identity":"20ae3983-55f3-489e-90d5-9c57a5e3b2db","added_by":"auto","created_at":"2024-11-20 09:01:00","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":17596,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of MRI readings of the sagittal view of the left TMJ between males and females.\u003c/p\u003e","description":"","filename":"9.png","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/f2c9dd6e8be7defce659a4e3.png"},{"id":71029039,"identity":"c2e0a6b9-7ed5-4e33-9c7e-55b8ca71ae74","added_by":"auto","created_at":"2024-12-10 11:17:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1997352,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5327858/v1/4a6d29f7-e188-4774-ab22-989de151b0e3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Three-dimensional evaluation of articular disc position and other temporomandibular joint morphology among Chinese patients with temporomandibular disorders: A retrospective MRI study","fulltext":[{"header":"1. Background","content":"\u003cp\u003eThe temporomandibular joint (TMJ) is a part of the craniofacial complex and one of the most complex synovial joints in the body. The most orthopedically stable TMJ position is when the condyles are in their most superoanterior position in the articular fossae, resting against the posterior slopes of the articular eminences, with the articular discs properly interposed, any changes in this position could be a factor in the development of temporomandibular disorders[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Temporomandibular disorders (TMDs) are a subgroup of craniofacial pain problems that involve the TMJ, masticatory muscles, and associated head and neck musculoskeletal structures [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Anterior disc displacement (ADD) is one of the most common subtypes of TMDs, and can be further divided into anterior disc displacement with reduction (ADDWR) and without reduction (ADDWoR), with the latter having more severe symptoms and greater difficulty in treatment. Other types of disc displacement but less common are posterior disc displacement (PDD), lateral disc displacement (LDD), and medial disc displacement (MDD) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePain, limited or asymmetrical mandibular motion, and TMJ sounds are the most frequent symptoms associated with TMDs[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The pain or discomfort is often localized to the jaw, TMJ, and muscles of mastication. Frequently associated symptoms may include ear pain, tinnitus, dizziness, neck pain, and headaches. Some individuals may experience a sudden onset with mild and self-limiting. However, in other cases, a chronic temporomandibular disorder may manifest, leading to ongoing pain and a range of physical, behavioral, psychological, and social symptoms resembling those seen in individuals with chronic pain disorders affecting other parts of the body (e.g., arthritis, back pain, headaches, and muscle strains)[\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe application of noninvasive imaging methods, such as magnetic resonance imaging (MRI), has significantly increased in the reported prevalence of TMJ disc disorders. In asymptomatic adult populations, the rates have increased from 30\u0026ndash;75%, and in symptomatic groups, they have increased from 12\u0026ndash;82%, and according to MRI findings, the prevalence of TMJ disc displacement is approximately 50% among preorthodontic adolescent boys and 75% among preorthodontic adolescent girls [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eSeveral studies have evaluated the association between TMJ disc status and craniofacial characteristics; in general, these studies have indicated that internal derangement of the TMJ is associated with several changes, including a decrease in ramus height, a shortened length of the mandibular body, and a diminished total posterior facial height. Additionally, the palatal and mandibular planes exhibit greater convergence in the posterior area, the vertical position of the maxillary molars is reduced, the sizes of both the anterior and posterior cranial bases are smaller, and the mandibular incisors are positioned more upright in relation to the mandibular plane [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe etiology and pathophysiology of TMDs, particularly internal derangement of the joint, remain unclear. Understanding the natural progression of disc displacement is crucial for developing an effective treatments for this condition [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Previous studies have not shown a clear link between joint space changes, condylar position, and degree of disc displacement in patients with TMD.\u003c/p\u003e \u003cp\u003eOur objective in this study is to thoroughly investigate the discal space changes, condylar position, and distance of disc displacement that occur in patients with TMD. Furthermore, we correlated these changes with other factors such as age, sex, and degree of disc displacement.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study population:\u003c/h2\u003e \u003cp\u003e This retrospective study was ethically approved by the Stomatological Hospital of Xi\u0026rsquo;an Jiaotong University Medical Ethics Committee under the ethical approval number: 2024-XJKQIEC-KY-QT-0035-002. From 2020\u0026ndash;2024, the medical records of patients who were referred to the orthodontics department and were diagnosed with TMD were examined. Informed consent was obtained from all subjects.\u003c/p\u003e \u003cp\u003eThe inclusion criteria were as follows: (1) patients who underwent MRI and CBCT scans for the purpose of diagnosing of TMDs with no restriction to a specific age; (2) had been diagnosed according to the DC/TMD Axis I [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]; and (3) had no previous orthodontic treatment. The exclusion criteria were as follows: (1) patients with previous TMJ surgeries or systematic diseases that would cause changes in the structure or physiology of TMJ or surrounding structures (e.g., rheumatoid arthritis, idiopathic juvenile arthritis, systematic lupus erythematosus, or osteoporosis); (2) patients with head and neck neoplasms and tumors; (3) patients with a history of congenital or developmental disorders(e.g. unilateral condylar hypoplasia or hyperplasia ) (4) patients with history of drugs that affect bone metabolism(e.g. calcitonin, bisphosphonate, and hormones), and (5) patient\u0026rsquo;s with poor MRI or CBCT image quality. Moreover, CBCT scans were evaluated to assess the presence of any type of osseous pathology of the TMJ, and any patient with marked osseous destruction was excluded.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003e2.1.1 Sample size calculation:\u003c/h2\u003e \u003cp\u003eThe minimum sample size was determined via GPower (Version 3.1.9.4) software, with α set at 0.05, a power of (1\u0026thinsp;\u0026minus;\u0026thinsp;β) at 0.8, and an effect size (f) of 0.3. The calculated minimum total sample size was 190 joints, which is less than the number of joints examined in the study.\u003c/p\u003e \u003cp\u003eThis study included 276 joints from 138 patients; however, 8 patients were excluded due to the poor MRI or CBCT image quality, thus the final sample studied sample was 130 patients (260 joints).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.2 MRI protocol:\u003c/h2\u003e \u003cp\u003eMRI scans were obtained using the United Imaging 3.0T MR scanner (uMR870) (United Imaging Healthcare, China). Proton density (PD) fast spin echo (FSE). MRI sequence in the closed mouth position (TR/TE; 2420/49.14; 8 slices; 2 mm slice thickness for both sagittal and coronal views; 100 mm FOV). The teeth were held in a maximum intercuspal position with the mouth closed, whereas each patient's maximum voluntary mouth opening was needed when their mouth was open during the MRI scanning of the open mouth position. All measurements and evaluations on both sagittal and coronal views were performed in the closed-mouth position because measurements in open-mouth position are not stable in TMD patients, the discrepancies in condyles, disc displacements, and limitation of mouth opening in some patients, all these are factors that may affect the measurements on open-mouth position views. However, the open-mouth position was used to differentiate between ADDWR and ADDWoR.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Image analysis:\u003c/h2\u003e \u003cp\u003eAll image analyses and measurements were conducted via RadiAnt DICOM Viewer (Medixant, Poznań, Poland). The sagittal slice showing the most significant deformation and displacement of the TMJ discs in the closed mouth position was selected for assessment. The patients' MRIs were reviewed, and all measurements and analyses were conducted by two investigators who received training from an experienced oral and maxillofacial radiologist. The intra-class correlation coefficient (ICC) was used to assess the inter- and intra-examiner reliability; Crombach\u0026rsquo;s alpha was \u0026gt;\u0026thinsp;0.8, which indicates excellent reliability.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 Joint space assessment:\u003c/h2\u003e \u003cp\u003eThe measurement and analysis of each MRI image were performed in two views (sagittal and coronal) in closed mouth position. In the sagittal view, as shown in (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, a \u003cb\u003eand b\u003c/b\u003e), three sites were measured, the anterior joint space AJS, central joint space CJS, and posterior joint space PJS. In this image, we drew a line parallel to the true horizontal line, passing through the deepest point at the condylar fossa, from this line, another perpendicular line was connected to the most superior point on the condyle to record the CJS. From the horizontal line, we dragged down 2 lines to touch the most anterior and posterior points on the condylar head as shown in the figure, and connected them to the most anterior and posterior points at the fossa to record the AJS and PJS, respectively. In the coronal view, two spaces were measured: the medial joint space (MJS) and the lateral joint space (LJS). Measurements were performed by drawing two lines from the middle of the mandibular fossa and dragging it obliquely to touch the medial pole and lateral pole, and then drawing another two perpendicular lines to measure the medial and lateral spaces, as shown in (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe condylar concentricity values were determined after the AJS and PJS were measured. We used the formula JSI= [(P \u0026ndash; A) \u0026divide; (P \u0026times; A)] \u0026times;100, where the JSI is the joint space index A is the anterior joint space and P is the posterior joint space. The positive values indicate an anteriorly positioned condyles in respect to the condylar eminence, while the negative values indicate a posteriorly positioned condyles.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 Determination of Disc Displacement:\u003c/h2\u003e \u003cp\u003eThe disc position was evaluated in the closed-mouth position. The ADD was defined as the most posterior edge of the articular disc being located anterior to the 12:00 position relative to the long axis of the condyle. Conversely, the PDD is determined when the posterior edge of the disc is posterior to the 12:30 position. Otherwise, the disc was determined to be normally positioned (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). A diagnosis of ADDWR and ADDWoR was made based on the open-mouth position MRI. Cases were classified as ADDWR when the intermediate zone of the disc was positioned between the condylar articular surface and the articular eminence. Conversely, cases were classified as ADDWoR. LDD and MDD were assessed via coronal imaging. A reference line was created along the long axis of the condylar pole and its neck (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Additionally, another line was drawn across the widest part of the condylar pole and divided into 10 equal segments. The position of the disc was noted in relation to these 1/10 divisions of the condylar width. Negative measurements indicated LDD, whereas positive measurements indicated MDD, with a value of 0 mm representing the normal position. The distance of disc displacement as shown in (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e, was determined by initially drawing the long-axis of the condyle (A-B) using the two-step method that was described by Nebbe et al. and Xie et al.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Two points were subsequently identified, point C was the intersection point between the long axis of the condyle and the contour of the condylar bone cortex, and point D is the most posterior point of the disc. The C-D distance was defined as the distance of disc displacement.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical analysis:\u003c/h2\u003e \u003cp\u003eThe Statistical Package for Social Sciences (SPSS) version 27.0 (IBM Corporation, Chicago, Ill) was used for statistical analyses. Twenty-five randomly selected MRI images were chosen, and the measurements were repeated by two investigators two weeks after the first measurement; the intra-class correlation coefficient (ICC) was used to assess the inter- and intra-examiner reliability. For the descriptive statistics, means and standard deviations were calculated. The Shapiro-Wilk test was performed to assess the distribution of the data; One-way ANOVA and Independent sample t-test used for the normally distributed variables; Kruskal-Wallis and Mann-Whitney u test used for non-normally distributed variables. Bivariate correlation was conducted using spearman correlation coefficients to investigate the relationship among age, disc position, and joint space dimensions.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Demographic characteristics:\u003c/h2\u003e \u003cp\u003eA total of 130 patients (260 joints) with a mean age of 24.7\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4 years were included in the present study. Among these patients, 34 (mean age 23.8\u0026thinsp;\u0026plusmn;\u0026thinsp;11.3) were male, and 96 (mean age 25\u0026thinsp;\u0026plusmn;\u0026thinsp;10.2) were female. There were 84 (32.3%) normal discs, 72 (27.6%) discs with ADDWR, 65 discs (25.3%) discs with ADDWoR, 24 (9.2%) with MDD,13 (5%) with LDD and 1 disc with Posterior displacement (PDD).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Joint spaces and disc position:\u003c/h2\u003e \u003cp\u003eMRI readings of the right side were not significantly different from those on the left side (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). On the right side of the sagittal view, the mean anterior joint space (AJS), central joint space (CJS) and posterior joint space (PJS) were 2.81 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66 mm), 3.24 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7 mm), and 2.91 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.52 mm), respectively. Similarly, on the left side, the mean values were, AJS 2.93 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7), CJS 3.34 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74 mm), and PJS 2.95 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5 mm). The mean value for condylar concentricity was 2.24% (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;12.7) on the right side and 0.96% (SD 13.5\u0026plusmn;) on the left side. Among the sagittal spaces the CJS was significantly the larger on both sides (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). On the right side of the coronal view, the mean values of the medial joint space (MJS) and lateral joint space (LJS) were 2.68 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.63 mm) and 2.59 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58 mm), respectively, and the ratio of MJS:LJS was 1:1.003. On the left side, MJS 2.68 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66 mm), LJS 2.76 mm (SD\u0026thinsp;\u0026plusmn;\u0026thinsp;0.59 mm), and the ratio of MJS:LJS is 1:1.07. Among the coronal spaces no significant difference was found (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, Figs.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e and \u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe mean and standard deviation of MRI readings of the sagittal and coronal view of the left and right TMJ.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnterior JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCentral JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSagittal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePosterior JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnterior JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCentral JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePosterior JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMedial JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLateral JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMedial JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLateral JS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026plusmn;\u0026thinsp;0.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen comparing joint spaces among sexes the right side AJS was significantly greater in females (2.9 mm) than in males (2.57 mm) (P\u0026thinsp;=\u0026thinsp;0.006), whereas the left side MJS was greater in males (3.04 mm) than in females (2.55 mm) (P\u0026thinsp;=\u0026thinsp;0.037). Furthermore, the left LJS was significantly greater in males (2.8 mm) than in females (2.52 mm) (P\u0026thinsp;=\u0026thinsp;0.026) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, Figs.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e and \u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of MRI readings of sagittal and coronal views of the left and right TMJ between males and females.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean(mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.57\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.006*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.9\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.06\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.26\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.10\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.711\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSagittal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.9\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.09\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.998\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.91\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.05\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.75\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.085\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.99\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.41\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.11\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.523\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.32\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.98\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.313\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.94\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.05\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.87\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.11\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.156\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.61\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.06\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.8\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0.001***\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.52\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.05\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCoronal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e3.04\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.12\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.026*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.55\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.06\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e34\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.87\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003e0.037*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e2.72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.06\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003eNote: ***: p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, **: p\u0026thinsp;\u0026lt;\u0026thinsp;.0.01, *: p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSimilarly, when the spaces between different age groups were compared, the CJS values on both sides were significantly lower in patients younger than 25 years (P\u0026thinsp;\u0026gt;\u0026thinsp;0.001); furthermore, among the spaces in the coronal view, the right MJS values were significantly lower in patients younger than 25 years patients (2.46 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58,\u003c/p\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001). (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the MRI readings of the sagittal and coronal views of the left and right TMJ between different age groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge Group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean (mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.739\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSagittal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.756\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.000**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eNote: ***: p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, **: p\u0026thinsp;\u0026lt;\u0026thinsp;.0.01, *: p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe mean of disc positions in the joints with normal discs, ADDWR and ADDWoR were (-1.16mm\u0026thinsp;\u0026plusmn;\u0026thinsp;1.46), (2.9mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78) and (5.25mm\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8) respectively.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Disc displacement:\u003c/h2\u003e \u003cp\u003eAfter the joints were divided into five groups according to the disc displacement diagnosis, a comprehensive analysis was performed to analyze all the variables among the different joints \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003eA\u003cb\u003e)\u003c/b\u003e. In normal discs, the AJS was significantly narrower among the sagittal spaces (2.74 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001), whereas the LJS was significantly narrower among the coronal spaces (2.61 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69, p\u0026thinsp;=\u0026thinsp;0.024). On the other hand, in patients with ADDWR, the AJS presented significantly greater values (3.08 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81, p\u0026thinsp;=\u0026thinsp;0.04). In joints with ADDWoR the spaces were not significantly different. Moreover, among the discs with MDD the MJS was significantly greater (3.14 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In contrast, the LDD was greater for the LJS (3 mm\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76, p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003eB shows the results when comparing joint spaces between normal joints, ADDWR, ADDWoR, MDD, and LDD. The condylar concentricity in the ADDWR was \u0026minus;\u0026thinsp;2.94 (\u0026plusmn;\u0026thinsp;10.9) while in ADDWoR was \u0026minus;\u0026thinsp;1.3(\u0026plusmn;\u0026thinsp;14.7), which indicates posteriorly positioned condyles. (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003eA\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the MRI readings of the coronal view of the left and right TMJ\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge Group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean (mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.002*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoronal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.127\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLJS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than 25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.693\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026ndash;44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003ebetween different age groups.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA: Joint space dimensions in normal disc position, ADDWR, ADDWoR, MDD and LDD.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDisc displacement\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eJoint space\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eMean\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eSD\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eAJS\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e84\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.74\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.55\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0.001***\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNormal joints\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCJS\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e84\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.63\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.73\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e84\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.97\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.43\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e84\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.76\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.69\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.024*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eLJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e84\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.61\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.5\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eAJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.08\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.81\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.04*\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eADDWR\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.8\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.47\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.55\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.63\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.101\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eLJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.72\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.77\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eAJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.7\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.68\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eADDWoR\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.2\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.68\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.02\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.62\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.61\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.61\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.156\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eLJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.82\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.68\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eAJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.4\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.47\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.003**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.96\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.56\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMDD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.84\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.51\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.51\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;0.001**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eLJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e24\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.1\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.47\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eAJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.71\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.48\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eCJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.47\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.65\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.003**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eLDD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ePJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.94\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.46\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.31\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.36\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003e0.001**\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eLJS\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e13\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e3.07\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003e0.76\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cem\u003eNote: ***: p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, **: p\u0026thinsp;\u0026lt;\u0026thinsp;.0.01, *: p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Correlation results between age, degree of displacement of articular disc and joint spaces:\u003c/h2\u003e \u003cp\u003eThe results of bivariate revealed a significant moderate to weak positive correlation between the age, AJS, CJS and MJS in ADDWR (\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\text{r}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = 0.408, 0.537, and 0,287, respectively). similarly, the correlation between age and MJS showed weak correlation ( \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\text{r}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = -0.253). However, there was no correlation between the degree of disc displacement and the joint spaces.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eTMD is considered to be the most prevalent orofacial pathology of non-dental origin [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. In joints with disc displacement, the shifted position of the disc in relation to the condyle is commonly known as internal derangement. Accurate localization of the disc is essential for diagnosing internal derangement of the TMJ[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The present study which was based on MRI, investigated the variables of TMJ spaces, disc position, and disc displacement distance among TMD patients; furthermore, it investigated the correlation among the disc displacement, joint spaces, and age of the patients.\u003c/p\u003e \u003cp\u003eMRI is a non-invasive imaging modality that does not use radiation and offers exceptional resolution of soft tissues. It has been recognized as the most precise method for assessing the position of the TMJ disc, thus earning it the designation of \"gold standard\" for this evaluation. Studies have indicated that the diagnostic accuracy of MRI for detecting disc displacement and deformity ranges from 80\u0026ndash;90%, suggesting that MRI measurements are highly precise.\u003c/p\u003e \u003cp\u003eThe position of the TMJ disc significantly affects the growth of the craniofacial region. If the disc is improperly positioned between the condyle and the articular eminence of the glenoid fossa, it may unfavourably affect the growth and development of the maxilla and mandible[\u003cspan additionalcitationids=\"CR16 CR17\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Studies have reported that TMJ disc displacement is associated with a decrease in forward growth of the maxilla and mandible, as well as reduced vertical growth of the ramus[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Flores-Mir C et al. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]also reported a decrease in posterior facial height with increasing anterior facial height, steep palatal and mandibular planes, vertically reduced maxillary molar position, and retroclined mandibular incisors, which are considered to be associated with TMJ disc displacement.\u003c/p\u003e \u003cp\u003eIn the present study there was a predominance of females, and this finding parallels the of a series of studies [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan additionalcitationids=\"CR20 CR21 CR22\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. There is no clear clue about the predominance of females with TMDs, but some studies have that theorised the demand for treatment is greater among females[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Another study suggested that the variation is attributed to alterations in collagen metabolism linked to genetic factors causing joint laxity [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].Other studies also suggest that female sex-hormone induce pro-inflammatory cytokines, aggravating TMJ inflammation[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Furthermore, in the present study, the prevalence of TMD peaked in population younger than 25 years old, which accordance with many studies that reported the peak prevalence of TMD in young and middle-aged adults[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn the present study, the majority of the TMJ discs were in a normal position. The predominant displacement observed was the ADDWR, followed by the ADDWR. In contrast, MDD and LDD were less frequently observed, whereas PDD was nearly absent. These findings are consistent with those reported by de Farias et al.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, several other studies indicate that the prevalence of ADDWoR is greater [\u003cspan additionalcitationids=\"CR31\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. These differences may be related to the studied sample\u0026rsquo;s characteristics[\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In our study, joint space analysis revealed no statistically significant difference when comparing the left and right sides, and this finding agrees with many studies [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDisplacement of the disc may lead to an alteration in the position of the condyle within the fossa, which in turn results in changes in the joint space. This alteration in the position of the condyle is influenced by both the direction and severity of disc displacement. The central joint space (CJS) was observed to be larger than the other joint spaces in the sagittal view. Whereas in the coronal MRI views, no significant differences were found between the medial and lateral joint spaces. The condylar concentricity (CC) showed decreased values, which indicates more posteriorly positioned condyles. AJS was significantly greater in the ADD than in normal discs, this finding is in line with K Ikeda\u0026rsquo;s study [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA Comparison joint spaces between sexes revealed that the AJS was significantly greater in females than in males, which may be attributed to the higher prevalence rate of anterior disc displacement observed in the females compared to males. Conversely, the lateral and medial joint space measurements were significantly greater in males tan females, a finding that is consistent with other studies [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. However, this finding disagrees with the results of the study conducted by Hansson et al. [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], who reported no significant difference in the values of the joint space between the sexes. In the present study, different age groups were shown to influence the joint spaces; both CJS and MJS showed lower values in young patients younger than 25 years.\u003c/p\u003e \u003cp\u003eIn our current study, we divided the joints according to the disc position, and we studied each group separately. In normal joints, we observed that the AJS was significantly the smaller than other joint spaces in the sagittal view, whereas the MJS was significantly greater than the LJS in the coronal view. However, the AJS was significantly larger than other sagittal spaces among ADDWR joints, this finding aligns with the findings of other studies [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], and may suggest that when the disc is advanced anteriorly, it would result in morphological changes due to the remodelling processes that may take place in both the condyle and the articular eminence due to the stretch of the tissues and the inflammatory process that could take place in the displaced disc areas. However, in the ADDWoR joints there was no significant difference between the spaces; which could be due to the adaptation process that may take part in these joints as the ADDWoR reflects a more chronic situation, thus, early addressing of the ADD is crucial, and trying to treat it when it is acute and reducible is much easier before advanced changes take place. The MDD joints had significantly larger MJS and small AJS, whereas the LDD joints had significantly larger LJS and CJS.\u003c/p\u003e \u003cp\u003eCompared with those in the ADDWR group, the TMJ discs in the ADDWoR group presented significant forward displacement. This observation indicates that as the displacement distance increased, the TMJ discs exhibited greater deformation and a tendency for ADDWoR. These findings are consistent with those of prior studies[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]; and this finding makes it easy to distinguish the ADDWoR from the closed-mouth position MRI.\u003c/p\u003e \u003cp\u003eOur study demonstrated a correlation between age and joint spaces in both the ADDWR and the ADDWoR. In the ADDWR, AJS, CJS, and MJS exhibited a positive correlation with age. This finding suggests that the severity of disc displacement and the likelihood of progression toward ADDWoR may increase with advancing age because, in previous studies, the AJS showed to be larger with displacements. Furthermore, in the ADDWoR group, only LJS exhibited a negative correlation with age. These findings suggest that further changes in the morphology of the condyle and fossa are unlikely in ADDWoR, as significant morphological alterations have already occurred along with the chronic nature, and adaptation to the new position of the articular disc will take place, accompanied by advanced clinical features, which may include a marked limitation in mandibular opening and associated symptoms. However, the degree of disc displacement did not correlate with age or joint space in either ADDWR or ADDWoR.\u003c/p\u003e \u003cp\u003eThe primary limitation of this study is the absence of healthy TMJ subjects as a control group. Instead, we compared the group with normal disc positions with groups of different disc displacements. This may account for the slightly greater joint space values observed in the group with normal disc positions than those reported in previous studies. Another limitation is that some variables that can be related to the TMD, such as the morphology of the condyles and disc, were not measured in this study.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eStudying joint spaces and the position articular disc in patients with temporomandibular disorders (TMDs) is clinically important as it can aids in accurate diagnosis, inform treatment planning, monitor progress and predict outcomes. This study enhances the understanding of the underlying pathophysiology of TMD, supports the development of evidence-based practices, and encourages interdisciplinary collaboration among healthcare providers. By correlating specific disc positions and joint space measurements with treatment outcomes, clinicians can tailor personalized care and improve overall patient management in this complex area. This study revealed that the CJS was larger than others, with sex differences in measurements. AJS was larger in females, whereas MJS and LJS were larger in males. In ADDWR group, the anterior joint space was significantly larger, whereas in ADDWoR, no significant differences were found. In ADDWoR the disc position was more advanced in position than that in ADDWR.\u003c/p\u003e \u003cp\u003eThe study also demonstrated that age was correlated with joint space measurements, suggesting that greater disc displacement severity might occur with increasing age. While the degree of displacement did not correlate significantly with age or joint spaces, the results emphasize the importance of early treatment for ADD to prevent chronic adaptations and structural changes in the TMJ. Overall, these findings provide insights into the implications of disc displacement for TMD diagnosis and management.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eTMJ Temporomandibular joint\u003c/p\u003e\n\u003cp\u003eTMD Temporomandibular disorder \u003c/p\u003e\n\u003cp\u003eCBCT Cone beam computed tomography\u003c/p\u003e\n\u003cp\u003eMRI Magnetic resonance imaging\u003c/p\u003e\n\u003cp\u003eAJS Anterior joint space\u003c/p\u003e\n\u003cp\u003eCJS Central joint space \u003c/p\u003e\n\u003cp\u003ePJS Posterior joint space\u003c/p\u003e\n\u003cp\u003eCC Condylar concentricity\u003c/p\u003e\n\u003cp\u003eMJS Medial joint space\u003c/p\u003e\n\u003cp\u003eLJS Lateral joint space\u003c/p\u003e\n\u003cp\u003eADDWR Anterior disc displacement with reduction\u003c/p\u003e\n\u003cp\u003eADDWOR Anterior disc displacement without reduction\u003c/p\u003e\n\u003cp\u003ePDD Posterior disc displacement\u003c/p\u003e\n\u003cp\u003eMDD Medial disc displacement\u003c/p\u003e\n\u003cp\u003eLDD Lateral disc displacement\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003eEthical approval and consent to participate\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThis retrospective study was ethically approved by the Stomatological Hospital of Xi\u0026rsquo;an Jiaotong University Medical Ethics Committee under the ethical approval number: 2024-XJKQIEC-KY-QT-0035-002. All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from all subjects.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable. \u003c/p\u003e\n\u003ch2\u003e \u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe data presented in this study are available on request from the corresponding author. The data are not publicly available due to ethical reasons. \u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003e Funding\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eS.W. is the correspondence of this work. Conceptualization, A.O., M.M., and C.D.; methodology, A.O. and C.D.; validation, A.O. and M.M.; formal analysis, Y.H., H.J.; investigation and radiograph measurements, A.O.; data curation, A.O.; writing\u0026mdash;original draft preparation, M.M.; writing\u0026mdash;review and editing, H.J., S.W.; supervision.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eNot applicable. \u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eAuthors\u0026apos; information \u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eORCID\u003c/p\u003e\n\u003cp\u003eAL Mustafa Osama https://orcid.org/0009-0009-0838-8701\u003c/p\u003e\n\u003cp\u003eMazen Musa https://orcid.org/0000-0002-4545-6314\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOkeson JP. Orthodontics Current Principles and Techniques vol. 6th Edition. 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Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112(4):453\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCai XY, Jin JM, Yang C. Changes in disc position, disc length, and condylar height in the temporomandibular joint with anterior disc displacement: a longitudinal retrospective magnetic resonance imaging study. J Oral Maxillofac Surg. 2011;69(11):e340\u0026ndash;346.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSato S, Sakamoto M, Kawamura H, Motegi K. Long-term changes in clinical signs and symptoms and disc position and morphology in patients with nonreducing disc displacement in the temporomandibular joint. J Oral Maxillofac Surg. 1999;57(1):23\u0026ndash;9. discussion 29\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhyte AM, McNamara D, Rosenberg I, Whyte AW. Magnetic resonance imaging in the evaluation of temporomandibular joint disc displacement\u0026ndash;a review of 144 cases. Int J Oral Maxillofac Surg. 2006;35(8):696\u0026ndash;703.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlqhtani N, Alkhaldi M, Alanazi A, Alabdulsalam A, Alenazi A, Zaman M, Alzahrani A, Alshadwi A, Rafedah A, Alotaibi M. Temporomandibular Joint Space Dimensions among Saudi Patients with Temporomandibular Disorders: MRI-Based Retrospective Study. Int J Clin Pract. 2022;2022:1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkur A, Ozkiris M, Kapusuz Z, Kara\u0026ccedil;avus S, Saydam L. Characteristics of articular fossa and condyle in patients with temporomandibular joint complaint. Eur Rev Med Pharmacol Sci. 2012;16(15):2131\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIkeda K, Kawamura A. Disc displacement and changes in condylar position. Dentomaxillofac Radiol. 2013;42(3):84227642.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKinniburgh RD, Major PW, Nebbe B, West K, Glover KE. Osseous morphology and spatial relationships of the temporomandibular joint: comparisons of normal and anterior disc positions. Angle Orthod. 2000;70(1):70\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHansson T, Oberg T, Carlsson GE, Kopp S. Thickness of the soft tissue layers and the articular disk in the temporomandibular joint. Acta Odontol Scand. 1977;35(2):77\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHu YK, Yang C, Xie QY. Changes in disc status in the reducing and nonreducing anterior disc displacement of temporomandibular joint: a longitudinal retrospective study. Sci Rep. 2016;6:34253.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Magnetic resonance imaging, Temporomandibular disorders, Temporomandibular joint, Internal derangement, Articular disc","lastPublishedDoi":"10.21203/rs.3.rs-5327858/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5327858/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe etiology and pathophysiology of temporomandibular disorders (TMDs), particularly the internal derangement of the joint, remain unclear. Accordingly, this study aimed to investigate the discal space changes, condylar position, and distance of disc displacement that occur in patients with temporomandibular disorder (TMD) and to explore joint space dimensions correlation to other factors such as age, sex, and distance of disc displacement.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 130 patients (260 joints) were included in this cross-sectional study. The magnetic resonance imaging (MRI) of each patient was used to evaluate the temporomandibular joint (TMJ) discal space dimensions in the coronal and sagittal sections, and the distance of disc displacement. One-way ANOVA and Independent sample t-test were used for the normally distributed variables, and Kruskal-Wallis, Mann-Whitney u test were used for non-normally distributed variables. Bivariate correlation was conducted using spearman correlation coefficients to investigate the relation between age, disc position, and joint space dimensions.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the sagittal spaces, the central joint space (CJS) was significantly larger on both sides (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). When comparing joint spaces among sexes, the right side anterior joint space (AJS) was significantly greater in females (p\u0026thinsp;=\u0026thinsp;0.006), while the left side medial and lateral joint spaces (MJS and LJS) were greater in males (p\u0026thinsp;=\u0026thinsp;0.037 and 0.026, respectively). Discal space dimensions showed to be narrower in patients younger than 25 years, particularly for the central and medial discal spaces (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The results of the bivariate analysis revealed a significant moderate to weak positive correlation between the age, AJS, CJS, and MJS in anterior disc displacement with reduction ADDWR (\u0026#119903;-2. = 0.408, 0.537, 0,287, respectively). Likewise, correlation between age and MJS showed weak correlation in anterior disc displacement without reduction ADDWoR (\u0026#119903;-2. = -0.253).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe central joint space is the largest among the other spaces. There are significant differences in joint space dimensions between sexes and age groups. Females have larger anterior joint spaces, whereas males present larger medial and lateral joint spaces. Additionally, younger individuals present narrower discal spaces, with age correlating moderately to weakly with joint space dimensions in cases of anterior disc displacement.\u003c/p\u003e","manuscriptTitle":"Three-dimensional evaluation of articular disc position and other temporomandibular joint morphology among Chinese patients with temporomandibular disorders: A retrospective MRI study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-20 09:00:55","doi":"10.21203/rs.3.rs-5327858/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e46d1177-1e36-4ecc-b0e2-90449cc49991","owner":[],"postedDate":"November 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-10T11:09:20+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-20 09:00:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5327858","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5327858","identity":"rs-5327858","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}