Laser applications in temporomandibular joint arthroscopic surgery

Abstract

It is a monumental accomplishment when new The carbon-dioxide laser was less practical due to the technology can improve the ability of a surgeon to render care to a patient. The advent of arthroscopic temporomandibular joint (TMJ) surgery is a modern example of that accomplishment. In 1975, Dr. Masatoshi Onishi [1] reported the first diagnostic TMJ arthroscopy. In the 1980s, McCain [2] and Sanders [3] independently in the United States, Murakami and colleagues [4–6] and Onishi [7] in Japan, and Hellsing and colleagues [8–12] in the Netherlands pioneered the techniques that are still used today for joint entry and treatment options for TMJ intra-articular pathology. At that time, the surgical equipment was bulky, cumbersome, and adapted to large-joint arthroscopic techniques. Over the years, technologic advances progressed, minimizing the shaver sizes and, eventually, developing electrocautery instrumentation. Although these developments dramatically improved the ability to treat the pathology within the TMJ, the technical limitation of this joint made surgery difficult. In the late 1980s, many practitioners in orthopedics and in oral and maxillofacial surgery were working with the Nd:YAG laser (wavelength 1.064 mm) and the carbon-dioxide laser (10.6 mm) for general surgical procedures and as replacement for cautery instrumentation in arthroscopic surgery. The experience of most surgeons was the same as published by Bradrick et al [13] in 1989. Lack of control of depth, tissue necrosis, and inability to work safely in a freebeam fashion limited the use of the Nd:YAG laser.