Prospective assessment of outcomes following disposable arthroscopy of the temporomandibular joint


      Temporomandibular disorder (TMD) is a common cause of chronic facial pain that is often treated successfully without operation, but when no improvement is seen arthroscopy may be considered as a therapeutic and diagnostic tool. We prospectively assessed the outcome of 115 arthroscopic procedures to assess the effectiveness and reliability of a 1.2 mm disposable arthroscope (OnPoint™, Biomet Microfixation, Jacksonville, USA). All patients included had not improved after standard conservative management. Discharge from clinic was classed as a successful outcome. Measurements taken before, during, and after operation included mouth opening and lateral deviations (mm). Pain was assessed before and after operation using a 10 cm visual analogue scale. Mean improvement in pain scores was 69% and in mouth opening was 19%, and overall success was 76%. Compared with a previous study using a 1.9 mm scope there were fewer complications after arthroscopy with the small diameter scope.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Dworkin S.F.
        Research diagnostic criteria for temporomandibular disorders: current status and future relevance.
        J Oral Rehabil. 2010; 37: 734-743
        • Manfredini D.
        • Bucci M.B.
        • Nardini L.G.
        The diagnostic process for temporomandibular disorders.
        Stomatologija. 2007; 9: 35-39
        • Manfredini D.
        • Piccotti F.
        • Ferronato G.
        • et al.
        Age peaks of different RDC/TMD diagnoses in a patient population.
        J Dent. 2010; 38: 392-399
        • Goldstein B.H.
        Temporomandibular disorders: a review of current understanding.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88: 379-385
        • Sidebottom A.J.
        Current thinking in temporomandibular joint management.
        Br J Oral Maxillofac Surg. 2009; 47: 91-94
        • Ahmed N.
        • Sidebottom A.J.
        • O’Connor M.
        • et al.
        Prospective outcome assessment of the therapeutic benefits of arthroscopy and arthrocentesis of the temporomandibular joint.
        Br J Oral Maxillofac Surg. 2012; 50: 745-748
        • Wilkes C.H.
        Internal derangements of the temporomandibular joint. Pathological variations.
        Arch Otolaryngol Head Neck Surg. 1989; 115: 469-477
        • Miyamoto H.
        • Sakashita H.
        • Miyata M.
        • et al.
        Arthroscopic surgery of the temporomandibular joint: comparison of two successful techniques.
        Br J Oral Maxillofac Surg. 1999; 37: 397-400
        • González-García R.
        • Rodríguez-Campo F.J.
        Arthroscopic lysis and lavage versus operative arthroscopy in the outcome of temporomandibular joint internal derangement: a comparative study based on Wilkes stages.
        J Oral Maxillofac Surg. 2011; 69: 2513-2524
        • Smolka W.
        • Yanai C.
        • Smolka K.
        • et al.
        Efficiency of arthroscopic lysis and lavage for internal derangement of the temporomandibular joint correlated with Wilkes classification.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: 317-323
        • Smolka W.
        • Iizuka T.
        Arthroscopic lysis and lavage in different stages of internal derangement of the temporomandibular joint: correlation of preoperative staging to arthroscopic findings and treatment outcome.
        J Oral Maxillofac Surg. 2005; 63: 471-478
        • Machoň V.
        • Šedý J.
        • Klíma K.
        • et al.
        Arthroscopic lysis and lavage in patients with temporomandibular anterior disc displacement without reduction.
        Int J Oral Maxillofac Surg. 2012; 41: 109-113
        • Leibur E.
        • Jagur O.
        • Müürsepp P.
        • et al.
        Long-term evaluation of arthroscopic surgery with lysis and lavage of temporomandibular joint disorders.
        J Craniomaxillofac Surg. 2010; 38: 615-620
        • Murakami K.
        • Moriya Y.
        • Goto K.
        • et al.
        Four-year follow-up study of temporomandibular joint arthroscopic surgery for advanced stage internal derangements.
        J Oral Maxillofac Surg. 1996; 54: 285-291
        • Fridrich K.L.
        • Wise J.M.
        • Zeitler D.L.
        Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders.
        J Oral Maxillofac Surg. 1996; 54: 816-821
        • Zhang S.
        • Huang D.
        • Liu X.
        • et al.
        Arthroscopic treatment for intra-articular adhesions of the temporomandibular joint.
        J Oral Maxillofac Surg. 2011; 69: 2120-2127
        • Murakami K.
        • Hosaka H.
        • Moriya Y.
        • et al.
        Short-term treatment outcome study for the management of temporomandibular joint closed lock. A comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 80: 253-257
        • Murakami K.I.
        • Tsuboi Y.
        • Bessho K.
        • et al.
        Outcome of arthroscopic surgery to the temporomandibular joint correlates with stage of internal derangement: five-year follow-up study.
        Br J Oral Maxillofac Surg. 1998; 36: 30-34
        • Israel H.A.
        Part 1: the use of arthroscopic surgery for treatment of temporomandibular joint disorders.
        J Oral Maxillofac Surg. 1999; 57: 579-582