Arthroscopic treatment for intra-articular adhesions of the temporomandibular joint

Shanyong Zhang, Dong Huang, Xiuming Liu, Chi Yang, Gerhard Undt, S Majd Haddad, Zhuozhi Chen
Journal of Oral and Maxillofacial Surgery 2011, 69 (8): 2120-7

PURPOSE: To introduce arthroscopic surgery of intra-articulator adhesion of the temporomandibular joint (TMJ) upper compartment and evaluate its effect.

PATIENTS AND METHODS: One hundred forty-two patients (159 joints) with intra-articular adhesions confirmed by arthroscope were treated with lysis of the adhesions, intra-articular cleanup surgery, or capsule radiofrequency catheter ablation. One hundred ten patients (123 joints) with disc displacement were treated with the disc repositioning and suturing technique. The follow-up index includes jaw movement, visual analog scale pain value, and patients' self-evaluation. The therapeutic effect was divided into excellent, good, and poor. Excellent and good patients were defined as effective. Jaw movement and visual analog scale pain value before and after the operation were evaluated by a paired t test.

RESULTS: The average follow-up period was 10.3 months (range: 2-27 months), and 33.80% (48/142) of all joints were excellent; 56.34% (80/142) were good, and 9.86% (14/142) were poor. The total effectiveness rate was 90.14% (128/142). Of all patients, 93.66% (133/142) felt more comfortable than they had before the operation. The interincisal opening increased from a preoperative 23.14 ± 5.93 mm (range: 10-40 mm) to postoperative 37.48 ± 3.51 mm (range: 30-40 mm; P < .01), and the pain scores were reduced from 28.94 ± 23.54 (0-80) to 4.44 ± 10.10 (0-40; P < .05).

CONCLUSION: The effect of arthroscopic surgery on temporomandibular joint intra-articular adhesion was positive. It can increase the mouth's range of motion, improve jaw function, and reduce pain during jaw movement.

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