Arthrotomography and the surgical correction of temporomandibular joint disorders

Over a 2-year-period, 321 new patients were seen at one clinic with temporomandibular joint dysfunction and pain. Sixty-seven (21%) of these who did not respond to 12 weeks medical therapy, had arthrotomography performed and 24 patients (7.5%) underwent surgery to the joint. Eighteen (75%) of these patients were free of pain 1 year later, although this success was not always sustained without medical therapy. Meniscus adhesions were under-estimated on arthrotomography compared to surgical findings and meniscus perforations were over diagnosed. However, increased accuracy in preoperative diagnosis was seen with experience. There was only one false positive result which lead to unnecessary surgery.