1
|
González-García R, Monje F. Complications of temporomandibular joint arthroscopy. A critical appraisal of the literature. J Craniomaxillofac Surg 2024:S1010-5182(24)00202-6. [PMID: 39030113 DOI: 10.1016/j.jcms.2024.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 04/06/2024] [Accepted: 06/09/2024] [Indexed: 07/21/2024] Open
Abstract
To search for the best available scientific evidence in relation to the reported overall and selective complication rates for arthroscopic surgery in patients presenting with internal derangement (ID) of the temporomandibular joint (TMJ). A comprehensive electronic search was conducted without data or language restrictions up to August 2023. Inclusion criteria were the following: study in humans, randomized or quasi-randomized controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies and series of clinical cases. The proposed PICOS question was: "In clinical trials and retrospective clinical series of patients treated by arthroscopy, which were the overall and selective complication rates?" Exclusion criteria were animal studies, review papers, technical reports, and in vitro studies. The Cochrane Collaboration Tool was used to assess the risk of bias of the included studies in terms of their quality. The Strength of Recommendation Taxonomy (SORT) classification was used to determine the level of evidence of the selected studies. A total of 498 studies were identified. Of these, 16 studies fulfilled the inclusion criteria and were selected for qualitative assessment. Temporary 5th nerve deficit, ranging from 0.15% to 2.38%, was reported to occur in most larger series, comprising 6975 operated joints. Temporary 7th nerve paresis was reported to occur in 0.21%-0.7% in the largest series, comprising 6866 operated joints. Partial hearing loss was reported in 6 studies, ranging from 0.21% to 2.2% in 5845 operated joints. Edema of surrounding soft tissues, including parapharyngeal, soft palate and/or preauricular edema was reported in 8 studies, with complication rates ranging from 2% to 17.9% in 3649 operated joints. Laceration of the EAC was reported in 8 studies involving 2665 operated joints, with complication rates ranging from 0.3% to 6%. A total of 646 complicated events among 11,304 operated joints were reported, accounting for an overall complication rate of 7.75%. Complications from arthroscopic procedures have been inconsistently reported, but there are a small number of retrospective studies with well-reported complications rates. As overall complication rate accounts for less than 8% of the cases, arthroscopy seems to be a highly safe procedure for the treatment of internal derangement (ID) of the TMJ. Due to the absence of studies with high evidence, information for patients about complications should be based on clinical series of cases.
Collapse
Affiliation(s)
- Raúl González-García
- Department of Oral and Maxillofacial-Head and Neck Surgery, Hospital Universitario de La Princesa, c/ Diego de León 62, Madrid, Spain.
| | - Florencio Monje
- Department of Oral and Maxillofacial Surgery, Hospital Universitario de Badajoz, Av. de Elvas s/n, Badajoz, Spain
| |
Collapse
|
2
|
Current Treatment Strategies for the Management of the Internal Derangements of the Temporomandibular Joint: A Global Perspective. J Maxillofac Oral Surg 2022; 21:1-13. [PMID: 35400919 PMCID: PMC8934796 DOI: 10.1007/s12663-021-01509-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/04/2021] [Indexed: 10/22/2022] Open
Abstract
Internal joint derangement is a disruption of the internal aspects of the TMJ-disc displacements/adhesions/impingements, causing alterations in the normal dynamic motions of the joint. Clinicians must be diligent in establishing the correct diagnosis and cause of TMJID, which ultimately leads to the appropriate management of such patients. While many patients adapt over time or with non-surgical treatment, surgery may be indicated for those with ongoing problems. The surgical pyramid provides a stepwise progression for TMJ surgical patients. This paper aims to review TMJID and its management with special emphasis on arthroscopic minimally invasive surgery, as practised in other countries around the world, and compare this to current education, understanding and practice in India. Currently, India is lagging behind in providing the full scope of TMJ services as there are very few surgeons trained in the skill of arthroscopic techniques. There needs to be continued expansion of our understanding of TMJID treatment in India to bring it level with the rest of the world.
Collapse
|
3
|
Askar H, Aronovich S, Christensen BJ, McCain J, Hakim M. Is Arthroscopic Disk Repositioning Equally Efficacious to Open Disk Repositioning? A Systematic Review. J Oral Maxillofac Surg 2021; 79:2030-2041.e2. [PMID: 33713607 DOI: 10.1016/j.joms.2021.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Temporomandibular joint disc repositioning surgery is 1 of the treatment modalities used for treating anterior disc displacement of the temporomandibular joint. The procedure can be arthroscopic disc repositioning or open disc repositioning. This systematic review measured and compared the efficacy of arthroscopic and open disc repositioning procedures. MATERIALS AND METHODS The authors conducted a systematic review without meta-analysis by performing a literature search electronically and manually covering arthroscopic and open disc repositioning studies published up to July 2020 in Pubmed, Embase, and Cochrane databases. Surgical outcomes such as changes in maximal incisal opening (MIO) and pain scores, temporomandibular joint noises, diet consistency, malocclusion, and postoperative complications were extracted and analyzed. RESULTS A total of 28 studies were included in the review and split into those assessing open disc repositioning (n = 13) and those assessing arthroscopic disc repositioning (n = 15). The average age of the study patients in the included studies was 31.5 ± 6.8 years, and women represented 83.3% of the study population. Both arthroscopic and open disc repositioning showed to be efficacious in reducing pain and increasing MIO. Due to heterogeneity in study designs and data reporting between the studies, no quantitative analysis was performed, and the groups were not directly compared. CONCLUSIONS Both arthroscopic and open disc repositioning led to significant improvements in clinical outcomes based on pain scores and MIO. This study highlights the need for comparative studies of the 2 techniques with well-documented case selection including standardized diagnosis based on Wilkes stages and rigorous outcomes assessment including patient reported outcomes.
Collapse
Affiliation(s)
- Houssam Askar
- DDS Candidate, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Sharon Aronovich
- Associate Professor, Department of Oral and Maxillofacial Surgery/Hospital Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Brian J Christensen
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University, New Orleans, LA
| | - Joseph McCain
- Director of TMJ Surgery and Minimally Invasive Surgery, Harvard School of Dental Medicine, Boston, MA
| | - Mohamed Hakim
- Assistant Professor, Department of Oral and Maxillofacial Surgery/Hospital Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI.
| |
Collapse
|
4
|
Modified arthroscopic anterior myotomy for internal derangement of the temporomandibular joint: clinical and radiological results. Int J Oral Maxillofac Surg 2020; 49:1311-1318. [DOI: 10.1016/j.ijom.2020.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/04/2020] [Accepted: 03/03/2020] [Indexed: 12/11/2022]
|
5
|
Abstract
PURPOSE OF REVIEW Elucidate temporomandibular joint (TMJ) development and pathophysiology relative to regeneration, degeneration, and adaption. RECENT FINDINGS The pharyngeal arch produces a highly conserved stomatognathic system that supports airway and masticatory function. An induced subperiosteal layer of fibrocartilage cushions TMJ functional and parafunctional loads. If the fibrocartilage disc is present, a fractured mandibular condyle (MC) regenerates near the eminence of the fossa via a blastema emanating from the medial periosteal surface of the ramus. TMJ degenerative joint disease (DJD) is a relatively painless osteoarthrosis, resulting in extensive sclerosis, disc destruction, and lytic lesions. Facial form and symmetry may be affected, but the residual bone is vital because distraction continues to lengthen the MC with anabolic bone modeling. Extensive TMJ adaptive, healing, and regenerative potential maintains optimal, life support functions over a lifetime. Unique aspects of TMJ development, function, and pathophysiology may be useful for innovative management of other joints.
Collapse
Affiliation(s)
- W Eugene Roberts
- School of Dentistry, Department of Orthodontics and Oral Facial Genetics, Indiana University-Purdue University (IUPUI), Indianapolis, IN, USA.
- Department of Orthodontics, Loma Linda University, Loma Linda, CA, USA.
- Advanced Dental Education, St. Louis University, St. Louis, MO, USA.
| | - David L Stocum
- School of Science, Department of Biology, Indiana University-Purdue University (IUPUI), Indianapolis, IN, USA
| |
Collapse
|
6
|
Liu X, Shen P, Wang X, Zhang S, Zheng J, Yang C. A Prognostic Nomogram for Postoperative Bone Remodeling in Patients with ADDWoR. Sci Rep 2018. [PMID: 29531236 PMCID: PMC5847608 DOI: 10.1038/s41598-018-22471-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
This study aimed to establish an effective prognostic nomogram for predicting the probability of postoperative bone remodeling of patients with anterior disc displacement without reduction (ADDWoR). The nomogram was based on a retrospective study on patients underwent surgical approaches for ADDWoR at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University from January, 2007 to January, 2017. A multivariate logistic regression analysis was used to develop variables suitable for probability estimation model. The predictive accuracy and discriminative ability were determined by ROC (AUC-index) and calibration curve. Results were validated using bootstrap resampling with all statistical tests two-sided. 1110 patients were included in the analysis. The probability of postoperative bone remodeling in ADDWoR was 0.51. Six independent prognostic factors including age of onset, nocturnal bruxism, disc morphology, BMD, Wilkes’ classification, and postoperative splint therapy were integrated to construct the nomogram. The probability estimation model showed good discrimination in both internal and external validation with AUC-index of 0.84. The calibration curves for probability of postoperative bone remodeling showed optimal agreement with actual observation. In conclusion, a nomogram was established to provide individual prediction of postoperative bone remodeling for patients with ADDWoR treated by arthroscopy surgery.
Collapse
Affiliation(s)
- Xiaohan Liu
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Shen
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangyu Wang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiawei Zheng
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Department of Oral-Maxillofacial Head and Neck Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. .,Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai, China.
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
7
|
Fernández Sanromán J, Costas López A, Fernández Ferro M, de Sánchez AL, Stavaru B, Arenaz Bua J. Complications of temporomandibular joint arthroscopy using two-portal coblation technologies: A prospective study of 475 procedures. J Craniomaxillofac Surg 2016; 44:1221-5. [DOI: 10.1016/j.jcms.2016.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/23/2016] [Accepted: 06/27/2016] [Indexed: 10/21/2022] Open
|
8
|
Discopexy using resorbable pins in temporomandibular joint arthroscopy: Clinical and magnetic resonance imaging medium-term results. J Craniomaxillofac Surg 2016; 44:479-86. [DOI: 10.1016/j.jcms.2016.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/09/2015] [Accepted: 01/04/2016] [Indexed: 11/20/2022] Open
|
9
|
Arthroscopic surgery for removal of 112 loose bodies of synovial chondromatosis of the temporomandibular joint. J Craniofac Surg 2015; 24:2166-9. [PMID: 24220430 DOI: 10.1097/scs.0b013e3182a2b82f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We present a new case of unilateral synovial chondromatosis of the temporomandibular joint, including diagnostic images, the treatment performed, and histologic analysis. In this report, we describe a case of temporomandibular joint synovial chondromatosis treated only through arthroscopy to remove 112 loose bodies completely.
Collapse
|
10
|
Treatment of Intermittent Locking of the Jaw in Wilkes Stage II Derangement by Arthroscopic Lysis and Lavage. J Oral Maxillofac Surg 2015; 73:1466-72. [DOI: 10.1016/j.joms.2015.02.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Revised: 02/06/2015] [Accepted: 02/27/2015] [Indexed: 11/22/2022]
|
11
|
Bouloux GF, Zerweck AG, Celano M, Dai T, Easley KA. Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy? J Oral Maxillofac Surg 2015; 73:2094-102. [PMID: 26032643 DOI: 10.1016/j.joms.2015.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 04/17/2015] [Accepted: 05/11/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Psychological assessment has been used successfully to predict patient outcomes after cardiothoracic and bariatric surgery. The purpose of this study was to determine whether preoperative psychological assessment could be used to predict patient outcomes after temporomandibular joint arthroscopy. MATERIALS AND METHODS Consecutive patients with temporomandibular dysfunction (TMD) who could benefit from arthroscopy were enrolled in a prospective cohort study. All patients completed the Millon Behavior Medicine Diagnostic survey before surgery. The primary predictor variable was the preoperative psychological scores. The primary outcome variable was the difference in pain between the pre- and postoperative periods. The Spearman rank correlation coefficient and the Pearson product-moment correlation were used to determine the association between psychological factors and change in pain. Univariable and multivariable analyses were performed using a mixed-effects linear model and multiple linear regression. A P value of .05 was considered significant. RESULTS Eighty-six patients were enrolled in the study. Seventy-five patients completed the study and were included in the final analyses. The mean change in visual analog scale (VAS) pain score 1 month after arthroscopy was -15.4 points (95% confidence interval, -6.0 to -24.7; P < .001). Jaw function also improved after surgery (P < .001). No association between change in VAS pain score and each of the 5 preoperative psychological factors was identified with univariable correlation analyses. Multivariable analyses identified that a greater pain decrease was associated with a longer duration of preoperative symptoms (P = .054) and lower chronic anxiety (P = .064). CONCLUSIONS This study has identified a weak association between chronic anxiety and the magnitude of pain decrease after arthroscopy for TMD. Further studies are needed to clarify the role of chronic anxiety in the outcome after surgical procedures for the treatment of TMD.
Collapse
Affiliation(s)
- Gary F Bouloux
- Associate Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Ashley G Zerweck
- Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Marianne Celano
- Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Tian Dai
- PhD Student, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kirk A Easley
- Senior Associate, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA
| |
Collapse
|
12
|
Tahim A, Goodson A, Payne K, Brennan P. A review of TMJ-related papers published in the British Journal of Oral and Maxillofacial Surgery in 2011 and 2012. Br J Oral Maxillofac Surg 2015; 53:e9-e12. [DOI: 10.1016/j.bjoms.2013.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 04/11/2013] [Indexed: 11/24/2022]
|
13
|
Al-Moraissi E. Arthroscopy versus arthrocentesis in the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2015; 44:104-12. [DOI: 10.1016/j.ijom.2014.07.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 07/11/2014] [Accepted: 07/14/2014] [Indexed: 10/24/2022]
|
14
|
Goizueta-Adame CC, Pastor-Zuazaga D, Orts Bañón JE. Arthroscopic disc fixation to the condylar head. Use of resorbable pins for internal derangement of the temporomandibular joint (stage II–IV). Preliminary report of 34 joints. J Craniomaxillofac Surg 2014; 42:340-6. [DOI: 10.1016/j.jcms.2013.05.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Revised: 05/28/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022] Open
|
15
|
Xu Y, Lin H, Zhu P, Zhou W, Han Y, Zheng Y, Zhang Z. A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis. PLoS One 2013; 8:e78953. [PMID: 24223868 PMCID: PMC3815200 DOI: 10.1371/journal.pone.0078953] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 09/24/2013] [Indexed: 11/19/2022] Open
Abstract
Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD) for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements.
Collapse
Affiliation(s)
- Yue Xu
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Han Lin
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Ping Zhu
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Wenyan Zhou
- Shanghai Ninth People's Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yi Han
- Department of Applied Mechanics and Engineering, Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Youhua Zheng
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
- * E-mail:
| | - Zhiguang Zhang
- Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China
| |
Collapse
|