Early Clinical Outcomes of Arthroscopic Management of the Failing Alloplastic Temporomandibular Joint Prosthesis

Use of a smartphone platform for temporomandibular joint arthroscopy

Temporomandibular joint (TMJ) arthroscopy, a diagnostic and therapeutic procedure involving the introduction of a small-calibre optical scope into the joint compartments for the treatment of internal derangement, has been gaining prominence and is now being recommended as the first therapeutic option due to the good results obtained and minimal invasiveness. However, the technical difficulty, high cost, need for specific instruments, and video tower system remain limiting factors for the implementation of TMJ arthroscopy by practicing professionals. The objective of this study was to examine the possibility of using a smartphone optical adaptation platform in TMJ arthroscopy. Ten qualified examiners with different levels of expertise in TMJ arthroscopy located four points of interest in the upper TMJ compartment of a validated realistic simulator and assessed the resolution of the images obtained and ergonomics of the smartphone platform for each point of interest, assigning a score of 0-2 (0 = poor, 1 = intermediate, and 2 = good performance in comparison to the video tower). For image quality, 77.5% of scores were 'good', while 22.5% were 'intermediate'. For ergonomics, 62.5% of scores were 'good' and 37.5% were 'intermediate'. In conclusion, the platform appears to be safe for TMJ arthroscopy in humans.

A New Technique for Arthroscopic Discectomy of the Temporomandibular Joint Disc Perforation: A Technical Note

Disc perforation represents the result of the degenerative process in joint structures that may lead to pain, joint noise, restricted mouth opening, osteoarthritis, and even dentofacial anomalies. Even though discectomy has proven benefits, with promising outcomes reported, it is mainly described using an open approach. While some arthroscopic techniques have been published, they are limited to managing perforation, edge widening, and inflammation treatment and do not describe complete disc removal. We describe a novel step-by-step arthroscopic discectomy technique utilizing two operative cannulas that completely remove nonfunctional cartilaginous tissue.

Recent Advances in Temporomandibular Joint Surgery

Temporomandibular disorders (TMDs) affect a high percentage of children and adults worldwide. Surgery may be indicated in severe or recalcitrant cases. Several recent advancements in TMD and temporomandibular joint (TMJ) surgery have elevated understanding and the ability to treat affected patients. We discuss recent advances in TMD epidemiology, juvenile idiopathic arthritis (JIA) of the TMJ, and surgical techniques and technologies. Technical advancements have been identified in TMJ arthroscopy, the treatment of TMJ subluxation and dislocation, and extended prosthetic total TMJ reconstruction (eTMJR). Overall, this review provides valuable insights into significant recent advancements in TMJ disorders and their surgical management.

Synovial entrapment in alloplastic temporomandibular joint replacement

Complications of alloplastic temporomandibular joint (TMJ) prostheses can lead to stress and anxiety for the patient and the surgical team, and prosthesis substitution is sometimes required. The aim of this case report is to describe the surgical finding of synovial entrapment with interposed fibrosis in a postoperative alloplastic TMJ revision, managed effectively with adequate surgical debridement. The authors believe that synovial entrapment needs to be considered as a possible postoperative complication of total joint replacement when no clear symptoms of infection, metal hypersensitivity, osteolysis, or heterotopic bone formation are present. The implications of synovial entrapment in TMJ alloplastic replacement remains relatively unpredictable and poorly understood.