Treatment of Intermittent Locking of the Jaw in Wilkes Stage II Derangement by Arthroscopic Lysis and Lavage

Abboud, W.; Yahalom, Ran; Givol, Navot

doi:10.1016/j.joms.2015.02.027

Cited by 15 publications

(5 citation statements)

References 49 publications

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“…The literature currently available is not conclusive on this topic [10,11,18] . On the one hand, it has been suggested that patients with less advanced disease tend to have higher success rates when treated with arthroscopy and that cases with more severe disease need open surgery for optimal long-term results [18][19][20][21] . On the other hand, it has been argued that arthroscopy ultimately provides fewer bene ts for stage II than for the most severely affected stages [10,22] .…”

Section: Discussionmentioning

confidence: 99%

Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy

Gaete

Droguett

Sáez

et al. 2023

Oral Maxillofac Surg

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High success rates and minimal complications have consolidated arthroscopy as the therapeutic alternative of choice for minimally invasive treatment of internal disorders (ID) of the temporomandibular joint (TMJ). However, there is no certainty regarding the demographic and clinical factors associated with the technique's success or failure. This study was performed to analyze the effectiveness of arthroscopy regarding pain and the mandibular dynamics and also to determine whether variables such as age, sex, preoperative Wilkes stage and the level of arthroscopy performed in uence the results. MethodsA retrospective study was conducted involving 92 patients with ID of the TMJ between September 2017 and February 2020. In all cases a rst stage of intra-articular lysis and lavage was executed. As needed, a phase of operative arthroscopy or arthroscopic discopexy were implemented. ResultsA total of 152 arthroscopies were performed. Both the variation in pain and mouth opening in patients with ID of the TMJ treated were statistically signi cant for the follow-up periods studied. Better results were observed for patients with lower Wilkes stages and for higher levels of arthroscopy performed. No association with age was found. ConclusionBased on the results, we recommend early intervention as soon as an ID in the TMJ is detected.

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Section: Discussionmentioning

confidence: 99%

Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy

Gaete

Droguett

Sáez

et al. 2023

Oral Maxillofac Surg

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“…On the current survey 93.9% disagreed with the statement "arthroscopic surgery is almost completely effective in repositioning the disk in patients with internal derangements", and 96.7% disagreed with the statement "an extensive history of previous treatment failures in a TMD patient is usually an indication for surgery" while on the original survey 100% of the respondents among the group of experts disagreed with both statements. The literature regarding arthroscopic surgery success in repositioning disk (30)(31)(32)(33), and regarding the indication for surgery in TMD patients (33,34) is not conclusive.…”

Section: Discussionmentioning

confidence: 99%

Knowledge and Beliefs Regarding TMD: Has Anything Changed After 20 Years?

et al. 2016

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Background: Due to the variety of factors involved in TMDs it is not surprising to see a wide range of treatment modalities being suggested for TMD patients. However, one determinant of treatment for TMD that is often overlooked is the practitioner's knowledge and beliefs about the syndrome itself. Objectives: To evaluate changes in experts' knowledge and beliefs regarding Temporomandibular Disorders (TMD) since the administration of the first such survey by Le Resche, Truelove and Dworkin in 1993. Patients and Methods: A survey invitation was emailed to 62 dentists and 19 psychologists, all determined to be experts in the orofacial pain/TMD field. All dentists selected to be part of this survey were members of the American Academy of Orofacial Pain. Psychologists were selected based on their publications in this field. The Le Resche et al. questionnaire was used with the following adaptations: four new statements were inserted; one statement was removed; and a 6-point Likert agreement scale for each statement was used instead of the original 11-point scale. Reminder emails were sent at one week and one month to maximize the response rate. Changes in responses to each item from the original survey were assessed using z-test. Results: Thirty-four dentists but only three psychologists responded to the survey. Therefore only responses from dentists were used in the analysis. Overall there was a high level of agreement between the original sample and the current sample. Of the 34 original items there was very clear consensus on 24. There was consensus on two new items in the survey on the need for a tomogram and splint therapy. Conclusions: Twenty years after the original survey, the knowledge and beliefs regarding TMDs among experts in this field have not changed significantly.

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“…At this stage, usually there is no constant limitation in mouth opening. [ 14 ] On the other hand, MIO should be considered the primary outcome variable for patients suffering from intermediate/late ID, as it reliably reflects the change after arthroscopy. There are different types of intracapsular TMJ disorders that are so different in diagnosis and treatment that they should not be lumped together when reporting the treatment results.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint

Abboud

Givol

Yahalom

2015

Ann Maxillofac Surg

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Introduction:Arthroscopy of the temporomandibular joint (TMJ) is a valuable diagnostic and therapeutic tool for various intra-articular disorders, especially internal derangement (ID) of the TMJ.Objectives:To evaluate the efficacy and safety of a standardized arthroscopic procedure for the treatment of two stages of ID; early/intermediate stage and intermediate/late stage.Materials and Methods:Retrospective analysis of medical records of 78 patients (99 joints) treated by arthroscopic lysis and lavage in the authors’ department during a 5-year period. Patients were diagnosed preoperatively as suffering from ID of the TMJ. The results were stratified according to the stage of ID. Three outcome variables were used to assess efficacy of treatment: Maximal interincisal opening (MIO), level of pain on a visual analog scale (VAS), and frequency of intermittent locking episodes. In addition, complications were reported.Results:Mean MIO of the group of patients with intermediate/late stage ID increased from 27 ± 4.7 mm preoperatively to 38 ± 5.4 mm postoperatively (P < 0.0001). For the group of patients with early/intermediate stage ID, mean MIO did not change significantly after arthroscopy (39.1 ± 6.2 mm compared to 41.4 ± 5 mm, P = 0.06), however, subjective evaluation of pain on a VAS decreased from 7.2 ± 1.2 preoperatively to 3.4 ± 2.2 postoperatively (P < 0.0001), and 80% of the patients (25 of 31) denied experiencing intermittent locking episodes after treatment (P < 0.0001).Conclusion:Arthroscopic lysis and lavage is a safe and effective therapeutic modality for the treatment of both mild and advanced stages of ID.

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Treatment of Intermittent Locking of the Jaw in Wilkes Stage II Derangement by Arthroscopic Lysis and Lavage

Cited by 15 publications

References 49 publications

Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy

Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy

Knowledge and Beliefs Regarding TMD: Has Anything Changed After 20 Years?

Arthroscopic lysis and lavage for internal derangement of the temporomandibular joint

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