Predictive factors in temporomandibular joint arthroscopy: a prospective cohort short-term outcome study

Ulmner, Mattias; Weiner, Carina Krüger; Lund, Bodil

doi:10.1016/j.ijom.2019.09.002

Cited by 12 publications

(17 citation statements)

References 27 publications

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“…Ulmner et al 24 in their retrospective report, settled the success criteria at MIO of ≥ 35 mm and pain score of ≤ 3 with a success rate of 67 %, without evaluation of diet or QOL, in addition, their report only investigated the outcomes following the arthroscopic lysis and lavage. The same research group prospectively analyzed the same patient speci c variables, revealing that an associated preoperative bilateral masticatory tenderness was the most signi cant factor affecting the surgical outcomes 25 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic Indicators of Yang’s Arthroscopic Technique for Management of Temporomandibular Joint Anterior Disc Displacement: Part 1- Clinical Predictors.

Sah

Abdelrehem

Chen

et al. 2021

Preprint

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In order to optimize the patient selection for specific treatment modality and to achieve favorable treatment outcomes, prognostic indicators impacting the results are important to analyze. This longitudinal retrospective study aimed to analyze various prognostic factors impacting the surgical outcomes following Yang’s arthroscopic discopexy for management of temporomandibular joint anterior disc displacement using success criteria based on pain, maximal interincisal opening, diet, and quality of life. Furthermore, a quantitative MRI assessment of disc position and condylar height was performed pre- and postoperatively. Multinomial analysis was used to evaluate various prognostic variables including gender, age, duration of illness, Wilkes staging, parafunctional habits, and splint/orthodontic therapy. A total of 169 patients (234 joints) were included. The outcome was categorized as excellent (n = 67/39.6%), good (n = 72/42.6%), improved (n = 22/13.01%) or poor (n = 8/4.73%) with a success rate of 95.26%. Patients aged from 11–15 years old were significantly more likely to be in the good outcome group (odds ratio (OR), 0.20; P < 0.05). Also, patients with shorter duration of illness (OR, 0.29; P < 0.05) and with Wilkes stage III (OR, 0.11; P < 0.05) were more likely to be in the improved outcome group. Better outcomes can be achieved at younger patients with shorter disease history and earlier Wilkes staging.

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Section: Discussionmentioning

confidence: 99%

Prognostic Indicators of Yang’s Arthroscopic Technique for Management of Temporomandibular Joint Anterior Disc Displacement: Part 1- Clinical Predictors.

Sah

Abdelrehem

Chen

et al. 2021

Preprint

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“…Patients with ADDwoR also tend to respond well on arthroscopy in other studies with success rates of up to 80%. 19 Part of the aetiology of ADDwoR is the presence of adhesions in the upper joint compartment.…”

Section: Discussionmentioning

confidence: 99%

“…With a subjective improvement of the main complaint in 62% of cases at short-term follow-up and 53% at medium-term follow-up, our success rates are rather low if compared to previous studies. 7,9,18,19,22 Ulmner and colleagues found in their short-term prospective study that 89% of patients with DJD, 80% of patients with ADDwoR and 64% of patients with chronic in ammatory arthritis bene ted from an arthroscopy. 19 Haeffs et al on the other hand only had a successful surgical outcome in 62.3% of patients with TMJ arthralgia or internal derangement.…”

Section: Discussionmentioning

confidence: 99%

“…Psychiatric disorders, concurrent use of benzodiazepines, high self-graded global pain, bilateral muscle tenderness at palpation and small MIO are all correlated with a negative outcome. 7,18,19 Because MRI and arthroscopy are commonly done in the refractory TMD patient group, it would be bene cial to identify which diagnostic ndings are associated with a higher success rate of the lysis and lavage effect of arthroscopy. The aim of this study therefore is to identify predictive variables to help physicians predict which patients might bene t the most from an arthroscopy.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of MRI and Arthroscopic Findings With Clinical Outcome in Temporomandibular Joint Disorders: A Retrospective Cohort Study

Vervaeke

Verhelst

Orhan

et al. 2021

Preprint

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Background: Arthroscopy is a minimally invasive diagnostic tool and treatment strategy in patients suffering from temporomandibular disorders (TMD) when conservative treatment fails. This study aimed to find specific variables on pre-operative MRI or during arthroscopy that could predict success of arthroscopic lysis and lavage.Methods: This retrospective analysis compared pre-operative maximum interincisal opening (MIO), pain and main complaint (pain, limited MIO or joint sounds) with results at short-term and medium-term follow-up (ST and MT respectively). Different variables scored on MRI or arthroscopy were used to make a stepwise regression model, subsequently a combined analysis was conducted using variables from both MRI and arthroscopy.Results: A total of 47 patients (50 joints) met the inclusion criteria. The main complaint improved by 62% and 53% at ST and MT respectively. The absolute or probable absence of a crumpled disc scored on MRI predicted success at ST and MT (p=0.0112 and p=0.0054), and remained significant at MT in the combined analysis (p=0.0078). Arthroscopic findings of degenerative joint disease predicted success at ST (p=0.0178), absolute or probable absence of discal reduction scored during arthroscopy significantly predicted success in the combined analysis at ST (p=0.0474).Conclusion: To improve selection criteria for patients undergoing an arthroscopic lysis and lavage of the TMJ, future research might focus on variables visualized on MRI. Although more research is needed, disc shape and in particular the absolute or probable absence of a crumpled disc might be used as predictive variable for success.

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“…Os desarranjos internos (DI) da ATM são transtornos dos componentes intra-articulares, como disco articular, sinóvia, líquido sinovial e fibrocartilagem, que limitam as funções da ATM. Os DI apresentam etiologia multifatorial 2 , sendo seu tratamento geralmente conservador, utilizando principalmente placas oclusais e anti-inflamatórios, apenas com um insucesso clínico, as modalidades cirúrgicas são indicadas [3][4][5] .…”

Section: Introductionunclassified

O uso da artroscopia para diagnóstico e tratamento dos distúrbios internos da articulação temporomandibular

Almeida

Leite

Hassam

et al. 2021

Rev. da Fac. de Odontologia, UPF

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Os desarranjos internos da articulação temporomandibular (ATM) são disfunções frequentes associadas aimportantes repercussões funcionais e dolorosas, como limitação de abertura bucal e ruídos articulares, quepodem provocar prejuízos à qualidade de vida do ser humano. Possuem etiologia multifatorial e são maisfrequentemente tratados conservadoramente através de fisioterapia, placas oclusais, psicoterapia, apoio farmacológico, apenas com o insucesso da terapia não cirúrgica é que as modalidades cirúrgicas são indicadas, em somente 2% a 5% dos casos. Dentre elas, a artroscopia se destaca como uma opção minimamente invasiva, com elevados índices de sucesso e baixas taxas de complicações, sendo um instrumento de alta sensibilidade que possibilita a visualização de diversas patologias intra-articulares, o diagnóstico e o tratamento desses distúrbios. Objetivo: revisar a literatura acerca das principais indicações da artroscopia no tratamento dos distúrbios internos da ATM, suas vantagens sobre as demais técnicas cirúrgicas e suas complicações. Considerações finais: a artroscopia é uma ferramenta eficiente e segura para o diagnóstico e o tratamento de diversos distúrbios internos da ATM em pacientes de diversas faixas etárias, destacando-se por seus altos índices de sucesso, menor tempo de internação e suas baixíssimas taxas de mortalidade.

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Predictive factors in temporomandibular joint arthroscopy: a prospective cohort short-term outcome study

Cited by 12 publications

References 27 publications

Prognostic Indicators of Yang’s Arthroscopic Technique for Management of Temporomandibular Joint Anterior Disc Displacement: Part 1- Clinical Predictors.

Prognostic Indicators of Yang’s Arthroscopic Technique for Management of Temporomandibular Joint Anterior Disc Displacement: Part 1- Clinical Predictors.

Correlation of MRI and Arthroscopic Findings With Clinical Outcome in Temporomandibular Joint Disorders: A Retrospective Cohort Study

O uso da artroscopia para diagnóstico e tratamento dos distúrbios internos da articulação temporomandibular

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