A Retrospective Study of Temporomandibular Joint Internal Derangement Treated with Arthrocentesis and Arthroscopy

Abstract

Introduction: Internal Derangement of the Temporomandibular Joint is an intra-articular condition in which there is a disruption in the normal relationship of the articular disc to the articular eminence and the condyle when the joint is at rest or in function. Patients may complain of pain and/or limitation of mouth opening. Treatment of internal derangement of temporomandibular joint includes arthrocentesis and arthroscopy. The aims of this retrospective study are to examine the efficacy of arthrocentesis and arthroscopy in the treatment of internal derangement of temporomandibular joint, specifically in relation to joint movement and pain. Methods: Twenty consecutive patients with internal derangement of temporomandibular joint seen in National Dental Centre of Singapore, from 2010 to 2011, were included in this study. Nine patients underwent arthrocentesis and 11 had arthroscopic lysis and lavage. The pre and postoperative pain score, in Visual Analogue Scale (0 to 10) and maximal inter-incisal opening were recorded to evaluate the effectiveness of both treatment modalities. The patients were reviewed one week and one month post-operation. The data obtained were statistically analysed. Results: Significant increase in postoperative mouth opening and reduction in pain were found in both groups of patients. In the arthrocentesis group, the mean increase in maximal inter-incisal opening was 13 ± 5mm and reduction of pain in VAS was 4.56 ± 1.74. For the arthroscopy group, the mean increase in maximal inter-incisal opening was 6.6mm ± 4.8mm and the reduction of pain was 2.5 ± 2.2. Duration of symptoms prior to treatment appeared to have influenced the treatment outcome of both treatments. Conclusion: Arthrocentesis and arthroscopy are effective in the treatment of internal derangement of temporomandibular joint. Factors that may influence treatment outcomes need to be investigated to provide more information on the predictability of arthrocentesis and arthroscopy.