Is Arthroscopic Disk Repositioning Equally Efficacious to Open Disk Repositioning? A Systematic Review

Area of Science:

• Oral and Maxillofacial Surgery
• Orthodontics
• Biomedical Engineering

Background:

• Anterior disc displacement of the temporomandibular joint (TMJ) often requires surgical intervention.
• Temporomandibular joint disc repositioning surgery, including arthroscopic and open procedures, is a common treatment.
• Evaluating the comparative efficacy of these surgical approaches is crucial for clinical decision-making.

Purpose of the Study:

• To systematically review and compare the efficacy of arthroscopic versus open temporomandibular joint disc repositioning surgery.
• To analyze surgical outcomes such as maximal incisal opening (MIO), pain reduction, and complications.

Main Methods:

• A systematic literature review was conducted, searching PubMed, Embase, and Cochrane databases up to July 2020.
• Included studies focused on arthroscopic or open disc repositioning for TMJ anterior disc displacement.
• Outcomes extracted included MIO, pain scores, TMJ noises, diet, malocclusion, and complications.

Main Results:

• Twenty-eight studies were analyzed, with 13 on open and 15 on arthroscopic procedures.
• Both surgical methods demonstrated efficacy in reducing pain and increasing MIO.
• Significant heterogeneity prevented direct quantitative comparison between the two techniques.

Conclusions:

• Both arthroscopic and open disc repositioning significantly improve clinical outcomes like pain and MIO.
• The study emphasizes the need for well-designed comparative studies.
• Standardized diagnostic criteria (e.g., Wilkes stages) and patient-reported outcomes are recommended for future research.