Abstract
The aim of this study was to investigate the clinical results and efficacy of an arthroscopic
approach to correct anterior displacement of the disc without reduction of the temporomandibular
joint (TMJ) with limitation of mouth opening. We studied 28 joints with internal derangement
in 23 patients, all of whom had had arthroscopic surgery (lavage, lysis of adhesions
in the superior compartment, incision parallel to the disc-synovial crease of the
upper joint compartment, and pull back of the anteriorly located disc). Objective
and subjective data (increase in maximal interincisal opening, magnetic resonance
imaging, and visual analogue pain score, VAS) were collected preoperatively and at
7, 30, 60 days, and 6 months or more postoperatively. Maximal interincisal opening improved
from a mean (SD) of 20.4 (±4.5) mm preoperative measurement to 38.9 (±3.2) mm by 6
months postoperatively where indicated in previous line. The VAS showed a significant
improvement in pain score (p = 0.0023). Sixty days postoperatively the positions of the discs in 14 of the TMJs had
improved considerably. In 13 of the TMJs the positions had improved slightly. Only
1 of the TMJs had not improved at all. There were no complications in any patient.
Our arthroscopic procedure is safe, minimally invasive, and effective for the treatment
of patients with displacement of the disc anteriorly without reduction of the TMJ.
Keywords
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Article info
Publication history
Published online: March 07, 2011
Accepted:
February 8,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
