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To evaluate the occurrence of temporomandibular joint disk displacement and its correlation with pain and osseous abnormalities using magnetic resonance imaging (MRI) in patients under 21 years of age.MRI images in open- and closed-mouth positions from 102 patients, under 21 years of age (mean age 17 years), were studied retrospectively. Patients were divided into six groups according to the disk–condyle relationship. Chi-square, Marascuilo procedure, and Cochran-Mantel-Haenszel tests were used to evaluate the relationships among pain, abnormalities, and the groups.There was a statistically significant correlation between bilateral disk displacement without reduction and pain (P = .011), and osseous changes (P < .0001). There was no proven link between pain and osseous abnormality (P = .414).Young patients are susceptible to all stages of disk displacement. There was a strong correlation only between each variable (osseous abnormalities and pain) and the most severe stage of disk displacement (bilateral disk displacement without reduction).