Arthroscopic laser surgery in temporomandibular functional joint disorders

Area of Science:

• Orthopedics
• Oral and Maxillofacial Surgery
• Arthroscopy

Background:

• Chronic closed lock of the temporomandibular joint (TMJ) often results from anterior disk displacement without reduction.
• Conservative treatments may fail, necessitating surgical intervention.

Purpose of the Study:

• To evaluate the 1-year outcomes of a combined arthroscopic approach for treating chronic closed lock of the TMJ.
• The combined approach includes lysis and lavage, capsular stretch, and holmium:yttrium-aluminium-garnet (Ho:YAG) laser techniques.

Main Methods:

• Ten patients with 12 affected TMJs underwent arthroscopic surgery after conservative treatment failure.
• Procedures involved lysis, lavage, capsular stretch, Ho:YAG laser treatment (anterior release, posterior scarification, debridement).
• Outcomes were assessed via clinical examination, visual analogue scale (VAS) for pain, and functional impairment questionnaires.

Main Results:

• A 90% success rate was observed, with 9 out of 10 patients showing improved mandibular function and reduced pain at 1 year.
• Clinical assessments at 1 year indicated good overall outcomes.
• Nine patients were able to consume a regular diet post-treatment.

Conclusions:

• The combined arthroscopic approach using Ho:YAG laser, lysis, lavage, and capsular stretch is effective for chronic TMJ closed lock.
• These arthroscopic procedures represent a viable first-line surgical treatment option.
• The technique offers significant functional improvement and pain reduction for TMJ disorders.