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Correlation between preoperative mandibular restriction and functional outcomes after arthroscopic discopexy for
Arthur Yen-Hung Lin1,2, Chih-Hua Yeh1,3, Ying-An Chen1,4
1College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Background/Purpose:
Arthroscopic discopexy is an established treatment for temporomandibular joint (TMJ) internal derangement, yet its functional benefit in patients with restricted mouth opening remains unclear. This study evaluate whether arthroscopic discopexy improves mouth opening and pain in patients with restricted mandibular mobility (maximum mouth opening [MMO] < 35 mm).
Materials And Methods:
This retrospective study included 46 patients (58 joints) with preoperative MMO < 35 mm who underwent TMJ arthroscopic discopexy between January 2023 and December 2024. MMO, Visual Analog Scale (VAS) pain scores, and MRI-confirmed disc repositioning success were compared preo- and postoperatively using the Wilcoxon signed-rank test. MMO improvement was analyzed by severity band with multiple linear regression to assess confounders and sensitivity analysis excluding bilateral cases.
Results:
MMO increased from 28.7 ± 4.1 mm to 34.2 ± 3.9 mm (P < 0.001), with a mean improvement of +5.5 mm (95% CI: +4.2 to +6.8). VAS decreased from 3.81 ± 2.93 to 0.18 ± 0.89 (P < 0.001). A dose-response relationship was observed: patients with MMO 20-24 mm gained +11.0 mm, those with 25-29 mm gained +7.5 mm, and those with 30-34 mm gained +2.7 mm. Preoperative MMO remained the only significant predictor after adjusting for confounders (B = -0.812, P < 0.001). Disc repositioning was achieved in 75.9% of joints; 55.2% achieved postoperative MMO ≥ 35 mm.
Conclusion:
Arthroscopic discopexy produces significant clinically improvements in mouth opening and pain in patients with restricted mandibular mobility, with the greatest benefit in those with the most severe restriction.