Abstract

AVELLA VECINO, F.J. et al. Arthroscopy for the internal derangement of TMJ: clinical outcome from a prospective evaluation. Rev Esp Cirug Oral y Maxilofac [online]. 2004, vol.26, n.2, pp.77-85. ISSN 2173-9161.

Objective. The tempormandibular joint dysfunction syndrome (TMJD) syndrome has a multifactorial etiology. Patients are considered operative candidates when nonsurgical therapy fails to adequately control symptoms. Our objective is to demonstrate the efficacy of arthroscopic lysis and lavage treatment for a homogeneous group of patients diagnosed of TMJD according to clinical-radiographic parameters. Design. This article reports a prospective study of 22 articulations (13 patients) diagnosed of internal derangement of TMJ and treated with lysis and lavage arthroscopy from February 1996 to April 2001. Before and after treatment as well as during the follow-up (range: 12-63 months, mean: 27 months), the following parameters were considered: pain, MIO, protrusive and laterotrusive mobility, noises, and MRI. Results. We performed a descriptive statistical study of continuous variables, comparing the pre- and postsurgery values with Wilcoxon and Mc Nemar tests, demonstrating a significant improvement during follow-up. Mann Whitney U Test was used for comparing pain and MIO between early and advanced stages, demonstrating a significantly greater improvement for early stages. The MRI results at one year of follow-up supports improvement in 27% (II-III Wilkes stages). According to Murakami criteria we obtained 23% excellent outcome, and 77% favorable outcome. Conclusions. Joint lysis and lavage is a useful and effectiveness method for treatment of internal derangement for early stages as well as for late stages, improving pain, MIO, protrusive and laterotrusive movements, and noises significantly. The improvement of MIO with arthroscopic lysis and lavage is greater for early stages.

Keywords : Arthroscopic surgery; Internal derangement; Temporomandibular joint; Lysis and lavage.

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