Temporo-Mandibular Joint Functional Arthroplasty: Does It Improve the Short-Term Quality of Life in Patients with Painful Anterior Disc Displacement Without Reduction? A Retrospective Cohort Study

<b>Background</b>: Anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) often leads to persistent pain and reduced quality of life (QoL). Conservative treatments frequently fail to provide adequate symptom relief. <b>Objective</b>: To assess the short-term (≥6 months) effectiveness of functional arthroplasty in reducing pain and improving QoL in patients with ADDwoR unresponsive to conservative therapies. <b>Methods</b>: A retrospective cohort study was conducted on 105 patients (median age 38 years, 80% female) treated at Santa Maria Hospital from January 2018 to December 2021. All patients had unilateral painful ADDwoR confirmed via MRI and underwent functional arthroplasty. Primary outcomes included pain reduction (VAS) and QoL improvements (QoL-TMJ questionnaire). Covariates such as age, gender, and baseline mood disturbances were analyzed for associations with surgical outcomes. Statistical analyses included the Wilcoxon rank test, Friedman's ANOVA, and Spearman's rank correlation. <b>Results</b>: Postoperative VAS scores significantly decreased (8.0 pre-op vs. 2.0 post-op, <i>p</i> < 0.001). QoL-TMJ scores improved significantly in pain (<i>p</i> < 0.001), activity (<i>p</i> < 0.05), mood (<i>p</i> < 0.001), and anxiety (<i>p</i> < 0.01), but no significant changes were observed in chewing and speaking functions. Improvements in QoL correlated strongly with pain reduction. Gender and age did not influence the outcomes, though females reported higher baseline mood disturbances. <b>Conclusions</b>: Functional arthroplasty effectively reduces pain and improves QoL in patients with ADDwoR, regardless of age or gender. However, limited improvement in chewing and speaking abilities highlights the need for targeted interventions. Future studies should assess the long-term outcomes to confirm the sustained benefits of this procedure.