Abstract
Aim This study assessed the patients' and clinicians' perception of the outcome of temporomandibular joint arthroscopy.
Method All patients who underwent TMJ arthroscopy for both diagnostic and therapeutic purposes over a 6-year period were sent a questionnaire that asked about various symptoms attributable to the TMJ. Additionally a review of the clinical notes was performed.
Results 83 patients underwent arthroscopy to 127 temporomandibular joints. The mean follow up was 3.6 years. 55% of patients assessed their jaw function as being effective, jaw movement, pain control, and overall satisfaction were satisfactory in 37%, 57%, and 48% of cases respectively. The clinicians' assessment revealed that 45% of patients had no joint tenderness, 74% of patients were able to open to > 35 mm and 74% of patients were free of any joint noise. 66% of patients were prepared to undergo a second procedure if indicated.
Conclusion Overall, 50% of patients seemed to view arthroscopy favourably although many patients still felt that jaw opening was restricted. The outcome was not related to the position and reducibility of the disc at surgery and other variables may be responsible. The disparity between the clinical evaluation and the patients' perception of effectiveness emphasises the importance of patient feedback.
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References
Dolwick M F, Dimitroulis G . Is there a role for temporomandibular joint surgery? Br J Oral Maxillofac Surg 1994; 32: 307–313.
Goss A N . Towards an international consensus on temporomandibular joint surgery. Int J Oral Maxillofac Surg 1993; 22: 78–81.
Fridrich K L, Wise J M, Zeitler D L . Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders. J Oral Maxillofoc Surg 1996; 54: 816–820.
Ohnishi M . Arthroscopy of the temporomandibolar joint. J Jpn Stomat 1975; 42: 207–212.
Davis C L, Kaminishi R M, Marshall M W . Arthroscopic surgery for treatment of closed lock. J Oral Maxillofac Surg 1991; 49: 704–707.
Gabler M J, Greene C S, Palacios E, Perry H T . Effect of arthroscopic temporomandibular joint surgery on articular disc position. J Craniomandib Disord Facial Oral Pain 1989; 3: 191–202.
Indresano A T . Arthroscopic surgery of the temporomandibular joint: report of 64 patients with long-term follow-up. J Oral Maxillofac Surg 1989; 47: 439–441.
Moses J J, Sartorius D, Glass R, Tanaka T, Poker I . The effects of arthroscopic surgical lysis and lavage of the superior joint space on the TMJ disc position and mobility. J Oral Maxillofac Surg 1989; 47: 674–678.
Nitzan D W, Dolwick M F, Heft M W . Arthroscopic lavage and lysis of the temporomandibular joint: a change in perspective. J Oral Maxillofac Surg 1 1990; 48: 798–801.
Sanders B . Arthroscopic surgery of the temporomandibular joint: treatment of internal derangement with persistent closed lock. Oral Surg Oral Med Oral Pathol 1986; 62: 361–372.
Sanders B, Buoncristiani R D . Diagnostic and surgical arthroscopy of the temporomandibular joint: clinical experiences with 137 procedures over a 2-year period. J Craniomand Disorders 1986; 8: 203–213.
White R D . Retrospective analysis of 100 consecutive surgical arthroscopies of the TMJ. J Oral Maxillofac Surg 1989; 47: 1014–1028.
Tarro W . Arthroscopic diagnosis and surgery of the TMJ. J Oral Surg 1988; 46: 282–289.
Israel H A, Roser S M . Patient response to temporomandibular joint arthroscopy: preliminary findings in 24 patients. J Oral Maxillofac Surg 1989; 47: 570–573.
Clark C T, Mood D G, Sanders B . Arthroscopic treatment of temporomandibular joint locking resulting from disc derangement: Two-year results. J Oral Maxillofac Surg 1991; 49: 157–164.
Holmlund A, Gynsher C, Axelsson S . Efficacy of arthroscopic lysis and lavage in patients with chronic locking of the temporomandibular joint. Int J Oral Maxillofac Surg 1994; 23: 262–265.
Dolwick M E, Dimitroulis C . A re-evaluation of the importance of disc position in temporomandibular disorders. Aust Dent J 1996; 41: 184–187.
Kircos L T, Ortendahl D A, Mark A S, et al. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg 1987; 45: 397–401.
Quinn J H . Identification of Prostaglandin E2 ond Leokotriene B4 in the synoviol fluid of painful, dysfuntional temporomandibular joints. J Oral Maxillofac Surg 1990; 48: 968–971.
Livesly P S, Doherty M, Needoff M, Malton A . Arthroscopic lavage of osteoarthritic knees. J Bone Joint Surgery (Br) 1991; 73B: 922–926.
Bjornland T, Rorvik M, Haanoes B R, Teige J . Degenerative changes in the temporomandibular joint after diagnostic arthroscopy. Int J Oral Maxillofac Surg 1994; 23: 41–45.
Sato S, Sakamoto M, Kawamura H, Motegi K . Long-term changes in clinical signs and symptoms and disc position and morphology in patients with nonreducing disc displacement in the temporomandibular joint. J Oral Maxillofac Surg 1999; 57: 23–29.
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Godden, D., Robertson, J. The value of patient feedback in the audit of TMJ arthroscopy. Br Dent J 188, 37–39 (2000). https://doi.org/10.1038/sj.bdj.4800381
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DOI: https://doi.org/10.1038/sj.bdj.4800381
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