Abstract

SILVA, Paulo Alexandre. Tmj arthroscopic lysis and lavage - an analysis of 102 patients and 175 joints. Rev. Assoc. Paul. Cir. Dent. [online]. 2014, vol.68, n.2, pp. 132-136. ISSN 0004-5276.

The treatment for internal derangement (ID) of the temporomandibular joint (TMJ), is a major challenge for surgeons and clinicians. Most often the treatment is performed conservatively using splints, physical therapy and medications. Only 2% to 5% of cases the treatment is surgical,Only 2-5% of patients require surgery, which is performed by arthroscopy or arthrotomy. In this study, 102 patients (175 temporomandibular joints) with temporomandibular joint (TMJ) internal derangement (ID),8 men, 94 women; mean age, 32.4 years, who were treated between January 2010 and October 2013 were included. These patients did not respond to conservative treatment and were diagnosed by clinical examination and magnetic resonance imaging (MRI) with limited mouth opening and localized functional temporomandibular joint pain. This study aimed to assess improvements in mouth opening, pain reduction, articular disc positioning, and postoperative complications of arthroscopic lysis and lavage (ALL) under general anesthesia. The patients underwent ALL and were monitored for a 12-month period with periodic evaluations. Of the 102 patients in the study, 9 (8,8%) required arthrotomy 6 months into the follow-up period, as they still presented with limited mouth opening and/or joint movement-associated pain. ALL was effective in 93.6% of the analyzed patients: 90.7% reported improved maximum interincisal opening (MIO), 93.6% experienced a decrease in joint movement-associated pain, and 68% reported improved disc positioning. The complications were transient and its rate was 6,9%.

Keywords : arthroscopy; temporomandibular joint disorders; temporomandibular joint.