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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
EDITORIAL THE TEMPOROMANDIBULAR JOINT
Italian Journal of Maxillofacial Surgery 2010 December;21(3 Suppl. 1):29-37
Minimally invasive arthroscopy of the temporomandibular joint
Sembronio S., Besozzi C., Baj A., Beltramini G., Giannì A. B.
Department of Maxillofacial Surgery, Maggiore Policlinico Hospital, University of Milan, Milan, Italy
Aim. The purpose of this study was to present a new method for treating internal derangement of the temporomandibular joint (TMJ) using a minimally invasive arthroscopy. The authors describe the technique, discuss the indications and evaluate the clinical outcome.
Methods. We performed minimally invasive arthroscopy as initial surgical procedure in 48 consecutive patients (35 female and 13 male) with unilateral TMJ dysfunction and joint pain not responding to nonsurgical treatment and magnetic resonance evidence of internal derangement. After the procedure, nonsteroidal antiinflammatory drugs, intensive phisiotherapy, soft died and interocclusal appliance were prescribed. A clinical examination with analysis of Maximal Mouth Opening, a Visual Analog Scale (VAS) and a self-administered questionnaire were used for evaluation of pain, jaw dysfunction, and activities of daily living (ADL). The follow-up period was 1 year.
Results. Diagnosis of intra-articular pathology was made and it was possible to stage all the patients following Wilkes classification. There were no complications related with minimally invasive arthroscopy. At 1-year follow-up, maximal mouth opening had increased significantly. Functional improvement was associated with a significant reduction in VAS, pain, dysfunction and ADL score. The overall success rate was 83,3%.
Conclusion. The results indicate that minimally invasive arthroscopy is an affective treatment improving function and reduction pain in patient with internal derangement of the temporomandubular joint. It could be considered as a first step in surgical cascade.