Could temporomandibular joint arthroscopic discopexy with resorbable pins or disc mobilisation influence mandibular condyle marrow?

Abstract

The aim of this study was to evaluate the relationship between arthroscopic discopexy with resorbable pins or disc mobilisation and its effect on the bone marrow of the mandibular condyle. An observational analytical retrospective cohort study was conducted. The inclusion criteria comprised adult patients with Wilkes IV and V with MRI in T2 sequence undergoing TMJ arthroscopy. The first group included subjects who received discopexy with pins (Level III Arthroscopy), and the second included subjects who underwent disc mobilisation without any fixation (Level IIb Arthroscopy). Variables studied were maximum interincisal opening (MIO), pain, and Signal Intensity Ratio (SIR) index. Data were analysed using the chi-squared test, Fisher’s exact test, the Mann Whitney U test, and the Shapiro-Wilk test. To establish the relationship between the variables and SIR ≥ 2, a multivariate analysis was performed using unconditional logistic regression. A total of 50 joints were divided in two groups. In the multivariate logistic regression analysis, discopexy surgery with pins (Odds Ratio OR = 0.03, 95% [CI] 0.02 to 0.69, p = 0.027) was identified as an independent predictor for the non-development of a high SIR score (≥2.0) after adjusting preoperative covariates. This study shows changes in the medullary signal in patients undergoing discopexy with resorbable pins. However, more studies are required that correlate quantitative measures.