Minimally invasive surgeries for the treatment of temporomandibular disorders: Prognostic indicators and persistence of treatment outcomes over a 5-year follow-up

Abstract

Background: Patients refractory to conservative treatment of temporomandibular disorders (TMD) are candidates for more invasive treatments such as arthroscopy and arthrocentesis. The aim of the present study was to identify the predictors of long-term success and the persistence of treatment outcome for temporomandibular joint (TMJ) arthroscopic lysis and lavage and arthrocentesis for the treatment of TMD. Methods: An analysis of 64 minimally invasive surgeries used to treat disk displacement without reduction in group I (n = 36), and osteoarthritis in group II (n = 28) was conducted. Success was identified as a pain score ≤ 3, disability score ≤ 2, and maximal mouth opening greater than 35 mm. Results: The overall success rate was 85.9%. The difference in success rate between groups was not significant (P = 0.441). Preoperative predictors of success in group I were fewer tender muscles (P < 0.01), shorter duration of symptoms (P = 0.046), lower pain (P < 0.01), and lower disability (P = 0.0104), whereas in group II there were fewer tender muscles (P < 0.01), less limitation in opening (P < 0.01), and lower disability (P = 0.0131). Conclusion: Arthroscopy and arthrocentesis were equally efficient after 5 years. Fewer tender muscles and lower disability preoperatively were common predictors of success. Pain recorded at 1 year, and maximum opening and disability recorded at 3 months were maintained after 5 years.

Keywords

• arthrocentesis
• arthroscopic lysis and lavage
• arthroscopy
• disk displacement without reduction
• osteoarthritis
• temporomandibular disorders
• temporomandibular joint
• temporomandibular joint pain