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Bilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention-a prospective study

2023-08-26Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Outras Ciências Médicas
datacite.subject.sdg03:Saúde de Qualidade
datacite.subject.sdg09:Indústria, Inovação e Infraestruturas
datacite.subject.sdg12:Produção e Consumo Sustentáveis
dc.contributor.authorÂngelo, David Faustino
dc.contributor.authorSanz, David
dc.contributor.authorCardoso, Henrique José
dc.date.accessioned2026-10-22T16:46:40Z
dc.date.available2026-10-22T16:46:40Z
dc.date.issued2023-08-26
dc.descriptionLink para o documento - https://davidangelo.org/wp-content/uploads/2023/10/1.pdf
dc.description.abstractObjective: Evaluate the efficacy of bilateral temporomandibular joint (TMJ) arthroscopy in patients with different categories of severity based on Dimitroulis classification (categories 2–4) and the role of a second TMJ intervention in primary failure. Methods: A 3-year prospective study was designed, including patients submitted to bilateral TMJ arthroscopy. The primary outcome was TMJ pain (VAS, 0–10) and the secondary outcomes were the maximum mouth opening (MMO) and masticatory myalgia degree (0–3). In cases of symptomatic relapse, a second TMJ intervention was performed (TMJ arthrocentesis or TMJ open surgery). Results: Eighty patients (93.4% women) were enrolled, with a mean age of 32.40 ± 11.41 years. With an average follow-up of 523.7 days (34–1606), a statistically significant improvement in TMJ pain, MMO, and myalgia degree was observed (P < 0.0001). The overall successful outcome of one-single bilateral arthroscopy was ~ 69%. Twenty-two patients relapsed: (1) arthralgia (n = 15, 68.18%); (2) arthralgia + myalgia (n = 4, 18.18%); (3) dislocated disc without reduction (DDwoR) (n = 2, 9.09%); (4) DDwoR + osteoarthrosis (OA) (n = 1, 4.55%). Arthralgia was re-managed with TMJ arthrocentesis with local anesthesia (n = 19, 86.36%). New DDwoR with or without OA was re-treated with TMJ open surgery (n = 3, 13.64%). After the second intervention, the success rate increased to 85%. Conclusions: Bilateral TMJ arthroscopy presented overall benefit in all parameters evaluated. Clinical relevance: This study highlights the importance of TMJ arthroscopy as the first line of treatment for moderate-severe temporomandibular disorders cases contributing to the reduction of TMJ open surgeries. In cases of arthroscopy unsuccess, TMJ arthrocentesis under local anesthesia was an effective and safe intervention for patients with recurrent TMJ arthralgia.eng
dc.identifier.citationÂngelo, D.F., Sanz, D. & Cardoso, H.J. Bilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention—a prospective study. Clin Oral Invest 27, 6167–6176 (2023). https://doi.org/10.1007/s00784-023-05233-6.
dc.identifier.doi10.1007/s00784-023-05233-6
dc.identifier.eissn1436-3771
dc.identifier.issn1432-6981
dc.identifier.urihttp://hdl.handle.net/10400.8/17108
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer Science and Business Media LLC
dc.relation.hasversionhttps://link.springer.com/article/10.1007/s00784-023-05233-6
dc.relation.ispartofClinical Oral Investigations
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectTemporomandibular joint disorders
dc.subjectArthroscopy
dc.subjectArthralgia
dc.subjectMyalgia
dc.subjectPain
dc.subjectMinimally invasive surgical procedures
dc.titleBilateral arthroscopy of the temporomandibular joint: clinical outcomes and the role of a second intervention-a prospective studyeng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage6176
oaire.citation.startPage6167
oaire.citation.titleClinical Oral Investigations
oaire.citation.volume27
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameÂngelo
person.givenNameDavid
person.identifier.ciencia-id2C1B-F1D5-5A08
person.identifier.orcid0000-0001-8411-9946
relation.isAuthorOfPublication6d9ebcd1-9dd6-48a8-916d-3ca7b9c912eb
relation.isAuthorOfPublication.latestForDiscovery6d9ebcd1-9dd6-48a8-916d-3ca7b9c912eb

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Objective: Evaluate the efficacy of bilateral temporomandibular joint (TMJ) arthroscopy in patients with different categories of severity based on Dimitroulis classification (categories 2–4) and the role of a second TMJ intervention in primary failure. Methods: A 3-year prospective study was designed, including patients submitted to bilateral TMJ arthroscopy. The primary outcome was TMJ pain (VAS, 0–10) and the secondary outcomes were the maximum mouth opening (MMO) and masticatory myalgia degree (0–3). In cases of symptomatic relapse, a second TMJ intervention was performed (TMJ arthrocentesis or TMJ open surgery). Results: Eighty patients (93.4% women) were enrolled, with a mean age of 32.40 ± 11.41 years. With an average follow-up of 523.7 days (34–1606), a statistically significant improvement in TMJ pain, MMO, and myalgia degree was observed (P < 0.0001). The overall successful outcome of one-single bilateral arthroscopy was ~ 69%. Twenty-two patients relapsed: (1) arthralgia (n = 15, 68.18%); (2) arthralgia + myalgia (n = 4, 18.18%); (3) dislocated disc without reduction (DDwoR) (n = 2, 9.09%); (4) DDwoR + osteoarthrosis (OA) (n = 1, 4.55%). Arthralgia was re-managed with TMJ arthrocentesis with local anesthesia (n = 19, 86.36%). New DDwoR with or without OA was re-treated with TMJ open surgery (n = 3, 13.64%). After the second intervention, the success rate increased to 85%. Conclusions: Bilateral TMJ arthroscopy presented overall benefit in all parameters evaluated. Clinical relevance: This study highlights the importance of TMJ arthroscopy as the first line of treatment for moderate-severe temporomandibular disorders cases contributing to the reduction of TMJ open surgeries. In cases of arthroscopy unsuccess, TMJ arthrocentesis under local anesthesia was an effective and safe intervention for patients with recurrent TMJ arthralgia.
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