Abstract
Patients who fail to respond to routine conservative measures to treat pain, restriction,
and locking in the temporomandibular joint (TMJ) may have therapeutic arthroscopy
or arthrocentesis, both of which are associated with symptomatic improvement in 86%
of patients. To our knowledge there are no current data on improvements in mouth opening
and lateral deviations after these procedures. This prospective audit includes 244
patients treated between 2005 and 2010 from one surgeon's practice, who were followed
up at least once at 6 weeks after arthroscopy or arthrocentesis. They had various
conditions but all had tender joints. Measurements of interincisal opening, left and
right lateral excursions, and protrusion were taken before and during operation with
callipers (mm). Opening and pain scores were also recorded on 10 cm analogue scales before operation and at 6 weeks. Pain scores improved with intervention
from a mean score of 37.1–16.1 (range 0–100). The improvement in mouth opening ranged
from 0 to 78% (as some patients had locking or pain with normal opening before operation),
and 86% had improved enough to be discharged at 6 weeks. Temporary forehead weakness
in two patients resolved within the timescale of the study. The study shows improvements
in mouth opening, and confirms that pain scores can be improved after arthroscopy
or arthrocentesis when conservative approaches have failed. In the hands of a skilled
practitioner, arthroscopy can be a useful diagnostic and therapeutic adjunct, which
can be used repeatedly with low morbidity.
Keywords
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Article info
Publication history
Published online: March 01, 2012
Accepted:
January 5,
2012
Identification
Copyright
© 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
