Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy

Abstract

Purpose High success rates and minimal complications have consolidated arthroscopy as the therapeutic alternative of choice for minimally invasive treatment of internal disorders (ID) of the temporomandibular joint (TMJ). However, there is no certainty regarding the demographic and clinical factors associated with the technique's success or failure. This study was performed to analyze the effectiveness of arthroscopy regarding pain and the mandibular dynamics and also to determine whether variables such as age, sex, preoperative Wilkes stage and the level of arthroscopy performed influence the results. Methods A retrospective study was conducted involving 92 patients with ID of the TMJ between September 2017 and February 2020. In all cases a first stage of intra-articular lysis and lavage was executed. As needed, a phase of operative arthroscopy or arthroscopic discopexy were implemented. Results A total of 152 arthroscopies were performed. Both the variation in pain and mouth opening in patients with ID of the TMJ treated were statistically significant for the follow-up periods studied. Better results were observed for patients with lower Wilkes stages and for higher levels of arthroscopy performed. No association with age was found. Conclusion Based on the results, we recommend early intervention as soon as an ID in the TMJ is detected.

Can the Autogenous Nanofat Injection Improve the Symptoms of Patients With Temporomandibular Joint Internal Derangement? A Prospective Observational Clinical Study

“…While stage III shows moderate pain, long-lasting locking, and disc displacement with or without reduction, stage IV features chronic pain, nonreducible disc displacement with limitation, and degenerative bony changes. Finally, stage V shows advanced disc displacement with adhesions, severe degenerative changes, subchondral bone changes, and disc perforation 7 …”

“…Finally, stage V shows advanced disc displacement with adhesions, severe degenerative changes, subchondral bone changes, and disc perforation. 7 The treatment modalities may vary from conservative noninvasive, minimally invasive, and invasive procedures according to the severity and etiology of the disorder. 8 Several conservative methods are available for managing ID.…”