The effect of arthroscopic surgical lysis and lavage of the superior joint space on TMJ disc position and mobility

Moses, Jeffrey J.; Sartoris, David J.; Glass, Renee; Tanaka, Terry T.; Poker, Ian D.

doi:10.1016/s0278-2391(89)80004-7

Cited by 157 publications

(45 citation statements)

References 7 publications

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“…Lavage of the upper joint space reduces pain by removing inflammatory mediators from the joint, increasing mandibular mobility by removing intra-articular adhesions, eliminating the negative pressure within the joint, recovering disc and fossa space and improving disc mobility, which reduces the mechanical obstruction caused by the anterior position of disc. [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

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Arthrocentesis for the Treatment of Internal Derangement of the Temporomandibular Joint

Neeli

Umarani

Kotrashetti

et al. 2010

J. Maxillofac. Oral Surg.

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Objective The study aims to evaluate the efficacy of arthrocentesis in the treatment of internal derangement of the temporomandibular joint (TMJ). Study Design Thirty patients with TMJ internal derangement underwent arthrocentesis using saline. Pain using visual analog scale, maximum mouth opening, joint noises and mandible deviation were documented pre-operatively and post-operatively. Patients were followed for 1 year. Statistical analysis of pain was done by Wilcoxon signed Rank's test and dysfunction by students paired t test. Results The mean pre-operative pain was 4.8 ± 2.65 and post-operatively at 1 year was 0.27 ± 0.45 with an average decrease of 4.72 (P = 0.000). The mean maximal mouth opening pre-operatively was 29.8 ± 2.35 mm and postoperatively 41.9 ± 2.48 mm at 1 year. The mean increase in the mouth opening was 12.1 ± 3.0 mm (P = 0.000). Conclusion Arthrocentesis is simple, minimally invasive procedure with less risk of complications and significant benefits in patients with TMJ internal derangement.Internal derangement of the temporomandibular joint (TMJ) is characterized by displacement of the intra-articular disc, resulting in clicking and popping sounds. However, the displacement of the articular disc does not always cause a mechanical obstruction. These conditions may be painless or they may be associated with pain, especially during function. The most common causes are trauma, which results in an immediate displacement of the disc, or chronic parafunction, which results in degenerative changes in the articular surfaces, increased friction, and gradual disc displacement.TMJ internal derangement has always presented as therapeutic challenge to the maxillofacial surgeons. Up to 25% of the entire population has internal derangement of TMJ and usually they are treated with nonsurgical methods such as medications, physiotherapy and occlusal splints in the initial period [1]. When these methods are unsuccessful, they are often managed by surgical methods. The mainstay of surgical treatment is based on changing the morphology or position of the disc, or removal of the disc with or without replacement. There are variable reports of success with the open surgical methodologies and are associated with surgical risks and potential long term sequelae [2].New insights into the joint pathology of internal derangement were provided by the observations made during TMJ arthroscopic lysis and lavage and outcomes after such treatment. The physical action of lysis and lavage in the superior joint space, rather than disc repositioning, is believed to be responsible for the success of arthroscopic surgery [3,4]. This has led to the use of TMJ arthrocentesis as a relatively less invasive alternative to reduce the inflammation in the superior joint space and restore normal range of motion [3]. The study aims to discuss the role of arthrocentesis in the treatment of internal derangement of the TMJ and present clinical data relating to the efficacy of arthrocentesis. Materials and MethodsThis prospective clinica...

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Section: Discussionmentioning

confidence: 99%

“…Nitzan et al first described arthrocentesis as the simplest form of surgery in the TMJ, aiming to release the articular disc and to remove adhesions between the disc surface and the mandibular fossa by means of hydraulic pressure from irrigation of the upper chamber of the TMJ [7,9,11].…”

Section: Discussionmentioning

confidence: 99%

Arthrocentesis for the Treatment of Internal Derangement of the Temporomandibular Joint

Neeli

Umarani

Kotrashetti

et al. 2010

J. Maxillofac. Oral Surg.

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“…Lavage of the upper joint space reduces pain by removing inflammation mediators from the joint (Quinn, Bazan, 1990), increasing mandibular mobility by removing intra-articular adhesions (Spallacia et al, 2000), eliminating the negative pressure within the joint, recovering disc and fossa space , and improving disc mobility, which reduces the mechanical obstruction caused by the anterior position of the disc (Moses et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

Artrocentese da articulação temporomandibular: avaliação de resultados e revisão da literatura

Vasconcelos¹,

Nogueira²,

Rocha

2006

Rev. Bras. Otorrinolaringol.

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OBJETIVO: Avaliar o efeito da artrocentese em relação à sintomatologia e movimentação mandibular em uma serie de pacientes com deslocamento anterior de disco e travamento mandibular. MATERIAIS E MÉTODOS: O estudo foi baseado nos dados pré e pós-operatório de pacientes através de exame clínico e radiográfico. A Escala Analógica Visual (EAV) foi usada para quantificar a dor no pré e pós-operatório. Foram avaliados 6 pacientes (12 articulações) tratados no Hospital Universitário Oswaldo Cruz (HUOC) com travamento mandibular (2 casos) e desarranjo interno (4 casos). O período médio de acompanhamento foi de 11,5 meses. RESULTADOS: A média de abertura bucal pré-operatória foi de 31,83mm e no pós-operatório foi de 36,50mm. A média de dor articular segundo a escala visual analógica encontrada foi de 7 e no pós-operatório foi de 4,3. CONCLUSÃO: A artrocentese mostrou-se efetiva na melhora da dor articular e na movimentação mandibular nesta série de casos.

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“…Excessive and repetitive mechanical stress has been implicated [19]. Inflammatory mediators and waste products may play a role in DJD [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49]. Inflammatory states cause changes in the viscosity of synovial fluid, which changes its ability to nourish the articular cartilage, thus changing cartilage metabolism.…”

Section: The Artritidesmentioning

confidence: 99%

Temporomandibular Disorders and BIO-IPNs: in vitro approach to find molecular solution to biological problem

Perchyonok¹,

Grobler²,

Basson³

et al. 2016

Nanomaterials and Regenerative Medicine

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The effect of arthroscopic surgical lysis and lavage of the superior joint space on TMJ disc position and mobility

Cited by 157 publications

References 7 publications

Arthrocentesis for the Treatment of Internal Derangement of the Temporomandibular Joint

Arthrocentesis for the Treatment of Internal Derangement of the Temporomandibular Joint

Artrocentese da articulação temporomandibular: avaliação de resultados e revisão da literatura

Temporomandibular Disorders and BIO-IPNs: in vitro approach to find molecular solution to biological problem

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