Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders

Purpose: A prospective, randomized study was undertaken to compare arthroscopy and arthrocentesis for treatment of temporomandibular joint disorders. Patients and Methods: Nineteen patients with clinical and radiographic documentation of internal derangement of the temporomandibular joint(s) unresponsive to nonsurgical therapy were randomized to one of two surgical groups: arthroscopic lysis and lavage under general anesthesia of arthrocentesis, hydraulic distention, and lavage under intravenous sedation, Objective data weve collected, including interincisal opening, lateral excursions, occlusal evaluation, deviation on opening, and tenderness to palpation. A questionnaire in the form of visual analog scales relating to pain, joint noise, jaw mobility, and dietary alterations was completed by each patient at 1 week, and 1, 3, 4, 12, and 26 months postoperatively. Results: There was no statistically significant difference in outcome between the two groups for any parameter evaluated, Categorization of a particular subject into a successful outcome was based on statistically significant improvement in maximum incisal opening and pain scores; the overall success rate was 82% for arthroscopy and 75% for arthrocentesis. Conclusions: Therapeutic success was not significantly different for arthroscopy and arthrocentesis; both surgical modalities ave useful for decreasing patient reports of pain while increasing functional mobility of the mandible.