Don't Rush into Braces with Disc Displacement: Experts Reveal the Science of Sequential Therapy

A new study published in Dental Research reveals that while proper orthodontics can help a healthy jaw joint, incorrect treatment can worsen disc displacement and even cause bone loss. The authors, from Shanghai Ninth People's Hospital, created a "Joint-Mandible-Occlusion" sequential model: first surgically reposition the disc, then address teeth alignment. This approach aims to fix the joint first to ensure stable, long-term results for both bite and facial appearance.

"The aim is to promote balanced bilateral joint growth in growing patients and maintain joint stability in adults," says co-corresponding author Chu Yang. "This idea underpins a pioneering approach to treating temporomandibular joint (TMJ) disc displacement, a common yet often misunderstood condition."

The authors noted that teenagers with receding chins or crooked teeth are usually told their issues were purely dental. "But the real cause is often the jaw joint itself: when the articular disc— a cartilage shock absorber—slips, it can erode the jawbone's condyle over time, leading to facial asymmetry, receding chins and misaligned bites," adds Yang. "This changes treatment entirely."

"Notably, traditional orthodontics alone often relapses, as the joint problem remains unaddressed. For adolescents, this unlocks balanced jaw growth; for adults, it stops bone erosion and restores joint stability," says Yang. "Many patients feel no pain, unknowingly suffering silent bone loss. Screening joint health before orthodontics is key—this root-cause approach delivers stable, long-term results, improving bite, facial harmony and jaw health."

Contact author:

Please contact Guo Bai and Qianyang Xie from Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University via surgeonb@163.com and Xieqianyang86@126.com.

Funder: 

This research was funded by the National Key R&D Program of China (2023YFC2509100), the Science and Technology Commission of Shanghai Municipality (23Y31900400), and the National Natural Science Foundation of China (82271038).

Conflict of interest: 

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

See the article:

Qianyang Xie, Guo Bai, Weizhe Sheng, Chi Yang, Zhiyuan Zhang, Anterior disc displacement in the temporomandibular joint and orthodontic treatment, Dental Research, Volume 1, Issue 1, 2026, 100001. DOI: https://doi.org/10.1016/j.dtrs.2025.100001.