alexa Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders.


Journal of Arthritis

Author(s): Fridrich KL, Wise JM, Zeitler DL

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Abstract PURPOSE: A prospective, randomized study was undertaken to compare arthroscopy and arthrocentesis for treatment of temporomandibular joint disorders. PATIENTS AND METHODS: Nineteen patients with clinical and radiographic documentation of internal derangement of the temporomandibular joint(s) unresponsive to nonsurgical therapy were randomized to one of two surgical groups: arthroscopic lysis and lavage under general anesthesia or arthrocentesis, hydraulic distention, and lavage under intravenous sedation. Objective data were collected; including interincisal opening, lateral excursions, occlusal evaluation, deviation on opening, and tenderness to palpation. A questionnaire in the form of visual analog scales relating to pain, joint noise, jaw mobility, and dietary alterations was completed by each patient at 1 week, and 1, 3, 4, 12, and 26 months postoperatively. RESULTS: There was no statistically significant difference in outcome between the two groups for any parameter evaluated. Categorization of a particular subject into a successful outcome was based on statistically significant improvement in maximum incisal opening and pain scores; the overall success rate was 82\% for arthroscopy and 75\% for arthrocentesis. CONCLUSIONS: Therapeutic success was not significantly different for arthroscopy and arthrocentesis; both surgical modalities are useful for decreasing patient reports of pain while increasing functional mobility of the mandible.
This article was published in J Oral Maxillofac Surg and referenced in Journal of Arthritis

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