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Clinical Oral Investigations

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26.08.2023 | Research

Bilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention—a prospective study

verfasst von: David Faustino Ângelo, David Sanz, Henrique José Cardoso

Erschienen in: Clinical Oral Investigations | Ausgabe 10/2023

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Abstract

Objective

Evaluate the efficacy of bilateral temporomandibular joint (TMJ) arthroscopy in patients with different categories of severity based on Dimitroulis classification (categories 2–4) and the role of a second TMJ intervention in primary failure.

Methods

A 3-year prospective study was designed, including patients submitted to bilateral TMJ arthroscopy. The primary outcome was TMJ pain (VAS, 0–10) and the secondary outcomes were the maximum mouth opening (MMO) and masticatory myalgia degree (0–3). In cases of symptomatic relapse, a second TMJ intervention was performed (TMJ arthrocentesis or TMJ open surgery).

Results

Eighty patients (93.4% women) were enrolled, with a mean age of 32.40 ± 11.41 years. With an average follow-up of 523.7 days (34–1606), a statistically significant improvement in TMJ pain, MMO, and myalgia degree was observed (P < 0.0001). The overall successful outcome of one-single bilateral arthroscopy was ~ 69%. Twenty-two patients relapsed: (1) arthralgia (n = 15, 68.18%); (2) arthralgia + myalgia (n = 4, 18.18%); (3) dislocated disc without reduction (DDwoR) (n = 2, 9.09%); (4) DDwoR + osteoarthrosis (OA) (n = 1, 4.55%). Arthralgia was re-managed with TMJ arthrocentesis with local anesthesia (n = 19, 86.36%). New DDwoR with or without OA was re-treated with TMJ open surgery (n = 3, 13.64%). After the second intervention, the success rate increased to 85%.

Conclusions

Bilateral TMJ arthroscopy presented overall benefit in all parameters evaluated.

Clinical relevance

This study highlights the importance of TMJ arthroscopy as the first line of treatment for moderate-severe temporomandibular disorders cases contributing to the reduction of TMJ open surgeries.

In cases of arthroscopy unsuccess, TMJ arthrocentesis under local anesthesia was an effective and safe intervention for patients with recurrent TMJ arthralgia.

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Titel: Bilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention—a prospective study
verfasst von: David Faustino Ângelo
David Sanz
Henrique José Cardoso
Publikationsdatum: 26.08.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 10/2023
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05233-6

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Bilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention—a prospective study

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

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Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

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