Prevalence of articular disc displacement among Thai TMD patients: a retrospective study on the association with demographic and clinical characteristics

Background: Disc displacement (DD) is among the most prevalent intra-articular temporomandibular disorders. Identifying associated factors can support early diagnosis and management. The objective of this study was to evaluate the relationship between disc conditions and patient demographics and clinical characteristics. Methods: This retrospective study analyzed 770 patient records collected from 2021 to 2025 using data extracted from the hospital’s digital system. Variables included demographic information, behavioral habits, occlusal characteristics, clinical findings, and temporomandibular joint (TMJ) diagnoses. Statistical analyses were performed using descriptive statistics, chi-square tests, independent t-tests, one-way analysis of variance, and binary logistic regression, with significance set at p < 0.05. Results: DD was diagnosed with 420 patients (54.5%). DD patients were significantly younger (mean 39.0 years, p < 0.001), predominantly in the 21–40 age group (p = 0.002), and more often female (72.0%, p < 0.001). Behavioral habits such as resting the chin on the hand (p < 0.001) and previous orthodontic treatment (p = 0.010) were more prevalent in the DD group. Occlusal characteristics, including overjet, overbite, midline deviation, and occlusal scheme, showed no significant association with DD. However, DD patients exhibited reduced posterior and total static articulation (p < 0.05), as well as decreased working contacts and increased non-working contacts during the right excursion. The distribution of TMJ clicking and disc diagnoses was comparable between the left and right sides. More advanced subtypes of DD were linked to younger age, female sex, reduced mouth opening capacity, and greater mandibular deviation. Conclusions: DD was associated with demographic and behavioral factors, particularly younger age, female sex, and certain oral habits. Functional occlusal contacts were also found to be associated with an increased likelihood of DD. Comprehensive assessment is essential for diagnosis and management.

Disc displacement; Temporomandibular joint; Occlusion; Risk factors; Mouth opening; Oral habits; TMD

[1] Lomas J, Gurgenci T, Jackson C, Campbell D. Temporomandibular dysfunction. Australian Journal of General Practice. 2018; 47: 212–215.

[2] Durham J, Newton-John TR, Zakrzewska JM. Temporomandibular disorders. The BMJ. 2015; 350: h1154.

[3] Zielinski G, Pajak-Zielinska B, Ginszt M. A meta-analysis of the global prevalence of temporomandibular disorders. Journal of Clinical Medicine. 2024; 13: 1365.

[4] Uma U, Sae-Tia K, Riewruja Y, Duphong P, Srisathaporn A. Incidence, diagnosis, and management of orofacial pain among new patients receiving tertiary care in Thailand: a 6-year retrospective study comparing before and during the COVID-19 outbreak. Journal of Oral Rehabilitation. 2024; 51: 2072–2081.

[5] Naeije M, Te Veldhuis AH, Te Veldhuis EC, Visscher CM, Lobbezoo F. Disc displacement within the human temporomandibular joint: a systematic review of a ‘noisy annoyance’. Journal of Oral Rehabilitation. 2013; 40: 139–158.

[6] Young AL. Internal derangements of the temporomandibular joint: a review of the anatomy, diagnosis, and management. The Journal of Indian Prosthodontic Society. 2015; 15: 2–7.

[7] Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al.; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the international RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of Oral & Facial Pain and Headache. 2014; 28: 6–27.

[8] Loan HK, Anh NTV, Duy TV, Hoa NT, Chien DQ, Au HD. Correlation between clicking sound symptoms and magnetic resonance imaging findings in patients with temporomandibular joint internal derangement. Medical Archives. 2025; 79: 155–158.

[9] Manfredini D. Etiopathogenesis of disk displacement of the temporomandibular joint: a review of the mechanisms. Indian Journal of Dental Research. 2009; 20: 212–221.

[10] Qu G, Bu L, Li X, You Q, Luo Y, Ma Z, et al. Malocclusion associated with temporomandibular joint anterior disc displacement and condylar resorption in adolescents: a cross-sectional study. Journal of Oral Rehabilitation. 2025; 52: 760–768.

[11] Badel T, Marotti M, Krolo I, Kern J, Keros J. Occlusion in patients with temporomandibular joint anterior disk displacement. Acta Clinica Croatica. 2008; 47: 129–136.

[12] Wang Q, Jia J, Zhou C, Ye W, Bi R. A bibliometric analysis of research on temporomandibular joint disc displacement from 1992 to 2022. Healthcare (Basel). 2023; 11: 2108.

[13] Pascu L, Haiduc RS, Almășan O, Leucuța DC. Occlusion and temporomandibular disorders: a scoping review. Medicina. 2025; 61: 791.

[14] Hagag G, Yoshida K, Miura H. Occlusion, prosthodontic treatment, and temporomandibular disorders: a review. Journal of Medical and Dental Sciences. 2000; 47: 61–66.

[15] Ohta M, Minagi S, Sato T, Okamoto M, Shimamura M. Magnetic resonance imaging analysis on the relationship between anterior disc displacement and balancing-side occlusal contact. Journal of Oral Rehabilitation. 2003; 30: 30–33.

[16] Aldowish AF, Alsubaie MN, Alabdulrazzaq SS, Alsaykhan DB, Alamri AK, Alhatem LM, et al. Occlusion and its role in the long-term success of dental restorations: a literature review. Cureus. 2024; 16: e73195.

[17] Cochran WG. Sampling techniques. 3rd edn. John Wiley & Sons: New York. 1977.

[18] The Glossary of Prosthodontic Terms 2023: Tenth Edition. The Journal of Prosthetic Dentistry. 2023; 130: e1–e3.

[19] Uma U, Tumrasvin W. Proposing a novel articulation classification for the occlusal examination in daily clinical practice and research. Natural and Life Sciences Communications. 2026; 25: e2026027.

[20] Talaat WM, Adel OI, Al Bayatti S. Prevalence of temporomandibular disorders discovered incidentally during routine dental examination using the Research Diagnostic Criteria for Temporomandibular Disorders. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2018; 125: 250–259.

[21] Yap AU, Dworkin SF, Chua EK, List T, Tan KB, Tan HH. Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients. Journal of Orofacial Pain. 2003; 17: 21–28.

[22] Shen P, Zhang D, Abdelrehem A, Jin S, Luo Y, Yang C. Association between sexual maturation and anterior disc displacement of temporomandibular joint in adolescents aged 13–14 years. Clinical Oral Investigations. 2022; 26: 7071–7081.

[23] Warren MP, Fried JL. Temporomandibular disorders and hormones in women. Cells Tissues Organs. 2001; 169: 187–192.

[24] Manfredini D, Stellini E, Gracco A, Lombardo L, Nardini LG, Siciliani G. Orthodontics is temporomandibular disorder-neutral. The Angle Orthodontist. 2016; 86: 649–654.

[25] Coronel-Zubiate FT, Marroquín-Soto C, Geraldo-Campos LA, Aguirre-Ipenza R, Urbano-Rosales LM, Luján-Valencia SA, et al. Association between orthodontic treatment and the occurrence of temporomandibular disorders: a systematic review and meta-analysis. Journal of Clinical and Experimental Dentistry. 2022; 14: e1032–e1043.

[26] Myllymäki E, Heikinheimo K, Suominen A, Evälahti M, Michelotti A, Svedström-Oristo AL, et al. Longitudinal trends in temporomandibular joint disorder symptoms, the impact of malocclusion and orthodontic treatment: a 20-year prospective study. Journal of Oral Rehabilitation. 2023; 50: 739–745.

[27] Hattori-Hara E, Mitsui SN, Mori H, Arafurue K, Kawaoka T, Ueda K, et al. The influence of unilateral disc displacement on stress in the contralateral joint with a normally positioned disc in a human temporomandibular joint: an analytic approach using the finite element method. Journal of Cranio-Maxillofacial Surgery. 2014; 42: 2018–2024.

[28] Hibi H, Ueda M. Body posture during sleep and disc displacement in the temporomandibular joint: a pilot study. Journal of Oral Rehabilitation. 2005; 32: 85–89.

[29] Huang D, Liu L, Zhai X, Wang Y, Hu Y, Xu X, et al. Association between chewing side preference and MRI characteristics in patients with anterior disc displacement of the temporomandibular joint. Journal of Stomatology, Oral and Maxillofacial Surgery. 2023; 124: 101484.

[30] Rocha T, Castro MA, Guarda-Nardini L, Manfredini D. Subjects with temporomandibular joint disc displacement do not feature any peculiar changes in body posture. Journal of Oral Rehabilitation. 2017; 44: 81–88.

[31] Zúñiga-Herrera ID, Aguilar-Pérez FJ, Escoffié-Ramírez M, Herrera-Atoche JR. Malocclusion complexity in patients with disc displacement disorders: a case-control study. Healthcare. 2023; 11: 2202.

[32] Manfredini D, Stellini E, Marchese-Ragona R, Guarda-Nardini L. Are occlusal features associated with different temporomandibular disorder diagnoses in bruxers? CRANIO®. 2014; 32: 283–288.

[33] Zhou GL, Yuan LJ, Li HR, Shi WT, Fang B. Prevalence of temporomandibular joint disc displacement in patients malocclusion. Shanghai Journal of Stomatology. 2024; 33: 656–660. (In Chinese)

[34] Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era? Journal of Oral Rehabilitation. 2017; 44: 908–923.

[35] Stone JC, Hannah A, Nagar N. Dental occlusion and temporomandibular disorders. Evidence-Based Dentistry. 2017; 18: 86–87.

[36] Ananthan S, Pertes RA, Bender SD. Biomechanics and derangements of the temporomandibular joint. Dental Clinics of North America. 2023; 67: 243–257.

[37] Wei M, Xie Y, Lv B, Niu W. Effect of occlusal interference on condylar position and trajectory of movement: a randomized crossover-controlled trial. BMC Oral Health. 2025; 25: 551.

[38] Huang T, Zhao SF, Song ZQ, Gong ZC. Quantitative MRI texture analysis of the lateral pterygoid muscle in unilateral temporomandibular joint disorders. Head & Face Medicine. 2025; 21: 34.

[39] Badel T, Vojnović S, Buković D, Zadravec D, Anić Milošević S, Smoljan Basuga M, et al. The asymmetry of the mandible in patients with unilateral temporomandibular joint disc displacement confirmed by magnetic resonance imaging. Acta Stomatologica Croatica. 2023; 57: 167–176.

[40] Yang C, Sun T, Shao B, Liu Z. Investigation of the biomechanical effects of severe anterior disc displacement on the temporomandibular joint and occlusion. Biomechanics and Modeling in Mechanobiology. 2025; 24: 1267–1277.

[41] Yoon SK, An JS, Huh KH, Ahn SJ. Differences in morphologies of the articular eminence and glenoid fossa according to disk displacement and sex. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2025; 140: 358–367.

[42] Zhang Q, Yuan S, Deng K, Li X, Liang Y, Wu A, et al. Correlation of patients’ demographics and clinical symptoms with temporomandibular disorders. CRANIO®. 2023; 41: 432–439.

[43] Anderson GC, Schulte JK, Aeppli DM. Reliability of the evaluation of occlusal contacts in the intercuspal position. The Journal of Prosthetic Dentistry. 1993; 70: 320–323.

[44] Abduo J, Tennant M. Impact of lateral occlusion schemes: a systematic review. The Journal of Prosthetic Dentistry. 2015; 114: 193–204.

[45] Sang S, Ameli N, Almeida FT, Friesen R. Association between clinical symptoms and MRI image findings in symptomatic temporomandibular joint (TMJ) disease: a systematic review. Journal of Cranio-Maxillofacial Surgery. 2024; 52: 835–842.

[46] Ikeda K, Kawamura A, Ikeda R. Prevalence of disc displacement of various severities among young preorthodontic population: a magnetic resonance imaging study. Journal of Prosthodontics. 2014; 23: 397–401.

[47] Silva MAG, Pantoja LLQ, Dutra-Horstmann KL, Valladares-Neto J, Wolff FL, Porporatti AL, et al. Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: a systematic review and meta-analysis. Journal of Cranio-Maxillofacial Surgery. 2020; 48: 942–955.

[48] Alqutaibi AY, Alhammadi MS, Hamadallah HH, Altarjami AA, Malosh OT, Aloufi AM, et al. Global prevalence of temporomandibular disorders: a systematic review and meta-analysis. Journal of Oral & Facial Pain and Headache. 2025; 39: 48–65.