The use of arthroscopy for the diagnosis and treatment of internal temporomandibular joint disorders
DOI:
https://doi.org/10.5335/rfo.v25i3.11619Keywords:
Artroscopia, Articulação Temporomandibular, Dor Orofacial, Transtornos da Articulação TemporomandibularAbstract
Internal temporomandibular joint (TMJ) derangements are frequent disorders associated with
major functional and painful repercussions, such as limited mouth opening and joint noise, which
may harm the quality of life of human beings. They have a multifactorial etiology and are most
often treated conservatively through physiotherapy, occlusal plaques, psychotherapy, and pharmacological
support. Surgical treatment is indicated only when non-surgical therapy fails, in 2% to 5% of cases. Among them, arthroscopy stands out as a minimally invasive option with high success rates and low complication rates, representing a highly sensitive instrument that allows visualizing several intra-articular pathologies, and diagnosing and treating these disorders. Objective: To review the literature on the main indications for arthroscopy in the treatment of internal TMJ disorders, its advantages over other surgical techniques, and its
complications. Final considerations: arthroscopy is an efficient and safe tool for the diagnosis and treatment of various internal temporomandibular joint disorders in patients of different age groups, standing out for its high success rates, shorter hospital stay, and low mortality rates.
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References
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disorders of the temporomandibular joints: Internal
derangement of the temporomandibular joint. Kaohsiung J
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https://doi.org/10.1016/j.kjms.2018.01.004.
2. Martin-Granizo R, Correa-Muñoz DC. Chondromalacia
as pathological finding in arthroscopy of the temporoman
dibular joint: a retrospective study. J Cranio-Maxillofacial
Surg [Internet] 2018; 46(1):82-9. Disponível em URL: http://
dx.doi.org/10.1016/j.jcms.2016.11.006.
3. da Silva PA, Lopes MT de FF, Freire FS. A prospective study
of 138 arthroscopies of the temporomandibular joint. Braz
J Otorhinolaryngol [Internet] 2015; 81(4):352-7. Disponível
em URL: http://dx.doi.org/10.1016/j.bjorl.2014.08.021.
4. Ulmner M, Weiner CK, Lund B. Predictive factors in temporomandibular
joint arthroscopy: a prospective cohort
short-term outcome study. Int J Oral Maxillofac Surg [Internet]
2020; 49(5):614-20. Disponível em URL: https://doi.
org/10.1016/j.ijom.2019.09.002.
5. Ulmner M, Kruger-Weiner C, Lund B. Patient-Specific Factors
Predicting Outcome of Temporomandibular Joint Arthroscopy:
a 6-Year Retrospective Study. J Oral Maxillofac
Surg [Internet] 2017; 75(8):1643.e1-1643.e7. Disponível em
URL: http://dx.doi.org/10.1016/j.joms.2017.04.005.
6. Muñoz-Guerra MF, Rodríguez-Campo FJ, Escorial-Hernández
V, Brabyn PJ, Fernández-Domínguez M, Naval-Gías
L. Modified arthroscopic anterior myotomy for internal derangement
of the temporomandibular joint: clinical and radiological
results. Int J Oral Maxillofac Surg 2020. Disponível
em URL: https://doi.org/10.1016/j.ijom.2020.03.004.
7. Choi DD, Vandenberg K, Smith D, Davis C, McCain JP. Is
Temporomandibular Joint Arthroscopy Effective in Managing
Pediatric Temporomandibular Joint Disorders in
the Short- and Long-Term? J Oral Maxillofac Surg [Internet]
2020; 78(1):44-51. Disponível em URL: https://doi.
org/10.1016/j.joms.2019.07.011.
8. Haeffs TH, D’Amato LN, Khawaja SN, Keith DA, Scrivani
SJ. What Variables Are Associated With the Outcome of Arthroscopic
Lysis and Lavage Surgery for Internal Derangement
of the Temporomandibular Joint? J Oral Maxillofac
Surg [Internet] 2018; 76(10):2081-8. Disponível em URL:
https://doi.org/10.1016/j.joms.2018.04.018.
9. Efeoglu C, Calis AS, Koca H, Yuksel E. A stepped approach
for the management of symptomatic internal derangement
of the temporomandibular joint. J Otolaryngol - Head Neck
Surg 2018; 47(1):1-7. Disponível em URL: https://doi.org/
10.1186 / s40463-018-0282-y.
10. Fernández Sanromán J, Fernández Ferro M, Costas López
A, Arenaz Bua J, López A. Does injection of plasma rich in
growth factors after temporomandibular joint arthroscopy
improve outcomes in patients with Wilkes stage IV internal
derangement? A randomized prospective clinical study. Int
J Oral Maxillofac Surg 2016; 45(7):828-35. Disponível em
URL: https://doi.org/10.1016 / j.ijom.2016.01.018.
11. Abboud W, Nadel S, Yarom N, Yahalom R. Arthroscopy of the
temporomandibular joint for the treatment of chronic closed
lock. Isr Med Assoc J 2016; 18(7):397-400. Disponível em
URL: https://pubmed.ncbi.nlm.nih.gov/28471560/.
12. Sato FRL, Lima CAA, Tralli G, da Silva RA. Is there a correlation
between arthroscopic findings and the clinical signs
and symptoms of patients with internal derangement of the
temporomandibular joint? A prospective study. Int J Oral
Maxillofac Surg [Internet] 2019; 48(2):233-8. Disponível em
URL: https://doi.org/10.1016/j.ijom.2018.07.004.
13. Lee LM, Zhu YM, Zhang D Di, Deng YQ, Gu Y. Synovial
Chondromatosis of the Temporomandibular Joint: A clinical
and arthroscopic study of 16 cases. J Cranio-Maxillofacial
Surg [Internet] 2019; 47(4):607-10. Disponível em URL:
https://doi.org/10.1016/j.jcms.2019.02.003.
14. Dimitroulis G. Outcomes of temporomandibular joint
arthroscopy in patients with painful but otherwise normal
joints. J Cranio-Maxillofacial Surg [Internet] 2015;
43(6):940-3. Disponível em URL: http://dx.doi.org/10.1016/j.
jcms.2015.03.035.
15. González-García R, Moreno-Sánchez M, Moreno-García C,
Román-Romero L, Monje F. Arthroscopy of the Inferior Compartment
of the Temporomandibular Joint: a New Perspective.
J Maxillofac Oral Surg 2018; 17(2):228-32. Disponível
em URL: https://doi.org/ 10.1007 / s12663-017-1023-x.
16. Breik O, Devrukhkar V, Dimitroulis G. Temporomandibular
joint (TMJ) arthroscopic lysis and lavage: Outcomes and rate
of progression to open surgery. J Cranio-Maxillofacial Surg
[Internet] 2016; 44(12):1988-95. Disponível em URL: http://
dx.doi.org/10.1016/j.jcms.2016.09.017.
17. Martin Granizo R, Correa Muñoz DC, Varela Reyes E. Rearthroscopy
of the temporomandibular joint: A retrospective
study of 600 arthroscopies. J Cranio-Maxillofacial Surg [Internet]
2018; 46(9):1555-60. Disponível em URL: https://doi.
org/10.1016/j.jcms.2017.12.007.
18. Muñoz-Guerra MF, Rodríguez-Campo FJ, Escorial-Hernández
V, Brabyn PJ, Fernández-Domínguez M, Naval-Gías L.
The minimally invasive arthroscopic anterior myotomy in
the treatment of internal derangement of the temporomandibular
joint. A detailed description of the surgical technique.
J Stomatol Oral Maxillofac Surg 2020. Disponível em URL:
https://doi.org/ 10.1016 / j.jormas.2020.04.006.
19. Pastore GP, Goulart DR, Pastore PR, Prati AJ. Removal
of a solitary synovial chondromatosis of the temporomandibular
joint using arthroscopy. J Craniofac Surg 2016;
27(4):967-9. Disponível em URL: https://doi.org/10.1097/
SCS.0000000000002612.
20. Bai G, Yang C, Qiu Y, Chen M. Open surgery assisted with
arthroscopy to treat synovial chondromatosis of the temporomandibular
joint. Int J Oral Maxillofac Surg [Internet] 2017;
46(2):208-13. Disponível em URL: http://dx.doi.org/10.1016/j.
ijom.2016.09.010.
21. Laviv A, Sadow PM, Keith DA. Pseudogout in the temporomandibular
joint with imaging, arthroscopic, operative, and
pathologic findings. Report of an unusual case. J Oral Maxillofac
Surg 2015; 73(6):1106-12. Disponível em URL: https://
doi.org/ 10.1016 / j.joms.2014.12.041.
22. Cariati P, Garcia Medina B, Galvez P, Cabello Serrano A,
Garcia Martin M, Valencia Moya G. Arthroscopic Eminoplasty
of Temporomandibular Joint: Surgical Technique. Craniomaxillofac
Trauma Reconstr 2018; 11(2):161-4. Disponível
em URL: https://doi.org/ 10.1055 / s-0038-1639349.
23. Martín-Granizo R. Simple and secure intra-articular infiltration
during arthroscopy of the temporomandibular joint. Br J
Oral Maxillofac Surg [Internet] 2018; 56(8):763-5. Disponível
em URL: https://doi.org/10.1016/j.bjoms.2018.07.004.
24. Martín-Granizo R, Maniegas L, Colorado L, Millon-Cruz A,
de Pedro M. Direct infiltration of botulinum toxin into the
pterygoid lateral muscle for repositioning of the disc during
arthroscopy of the temporomandibular joint. Br J Oral Maxillofac
Surg 2018; 56(8):769-71. Disponível em URL: https://
doi.org/10.1016/ j.bjoms.2018.07.014.
25. Hossameldin RH, McCain JP. Outcomes of office-based
temporomandibular joint arthroscopy: a 5-year retrospective
study. Int J Oral Maxillofac Surg [Internet] 2018;
47(1):90-7. Disponível em URL: http://dx.doi.org/10.1016/j.
ijom.2017.06.025.
26. Fernández Sanromán J, Costas López A, Fernández Ferro
M, de Sánchez AL, Stavaru B, Arenaz Bua J. Complications
of temporomandibular joint arthroscopy using twoportal
coblation technologies: a prospective study of 475
procedures. J Cranio-Maxillofacial Surg [Internet] 2016;
44(9):1221-5. Disponível em URL: http://dx.doi.org/10.1016/j.
jcms.2016.06.027.
27. Al-Moraissi EA. Open versus arthroscopic surgery for the
management of internal derangement of the temporomandibular
joint: a meta-analysis of the literature. Int J Oral
Maxillofac Surg [Internet] 2015; 44(6):763-70. Disponível em
URL: http://dx.doi.org/10.1016/j.ijom.2015.01.024.
28. Leonardi R, Crimi S, Almeida LE, Pannone G, Musumeci G,
Castorina S, et al. ADAMTS-4 and ADAMTS-5 expression
in human temporomandibular joint discs with internal derangement,
correlates with degeneration. J Oral Pathol Med
2015; 44(10):870-5.
29. American Society of Temporomandibular Joint Surgeons.
Guidelines for diagnosis and management of disorders involving
the temporomandibular joint and related musculoskeletal
structures. American Society of Temporomandibular
Joint Surgeons. Northwest Dent 2005; 71(5):21-7.
30. Cho J, Israel H. Does the Age of a Patient Affect the Outcome
of Temporomandibular Joint Arthroscopic Surgery? J Oral
Maxillofac Surg [Internet] 2017; 75(6):1144-50. Disponível
em URL: http://dx.doi.org/10.1016/j.joms.2016.10.038.
disorders of the temporomandibular joints: Internal
derangement of the temporomandibular joint. Kaohsiung J
Med Sci [Internet] 2018; 34(4):223-30. Disponível em URL:
https://doi.org/10.1016/j.kjms.2018.01.004.
2. Martin-Granizo R, Correa-Muñoz DC. Chondromalacia
as pathological finding in arthroscopy of the temporoman
dibular joint: a retrospective study. J Cranio-Maxillofacial
Surg [Internet] 2018; 46(1):82-9. Disponível em URL: http://
dx.doi.org/10.1016/j.jcms.2016.11.006.
3. da Silva PA, Lopes MT de FF, Freire FS. A prospective study
of 138 arthroscopies of the temporomandibular joint. Braz
J Otorhinolaryngol [Internet] 2015; 81(4):352-7. Disponível
em URL: http://dx.doi.org/10.1016/j.bjorl.2014.08.021.
4. Ulmner M, Weiner CK, Lund B. Predictive factors in temporomandibular
joint arthroscopy: a prospective cohort
short-term outcome study. Int J Oral Maxillofac Surg [Internet]
2020; 49(5):614-20. Disponível em URL: https://doi.
org/10.1016/j.ijom.2019.09.002.
5. Ulmner M, Kruger-Weiner C, Lund B. Patient-Specific Factors
Predicting Outcome of Temporomandibular Joint Arthroscopy:
a 6-Year Retrospective Study. J Oral Maxillofac
Surg [Internet] 2017; 75(8):1643.e1-1643.e7. Disponível em
URL: http://dx.doi.org/10.1016/j.joms.2017.04.005.
6. Muñoz-Guerra MF, Rodríguez-Campo FJ, Escorial-Hernández
V, Brabyn PJ, Fernández-Domínguez M, Naval-Gías
L. Modified arthroscopic anterior myotomy for internal derangement
of the temporomandibular joint: clinical and radiological
results. Int J Oral Maxillofac Surg 2020. Disponível
em URL: https://doi.org/10.1016/j.ijom.2020.03.004.
7. Choi DD, Vandenberg K, Smith D, Davis C, McCain JP. Is
Temporomandibular Joint Arthroscopy Effective in Managing
Pediatric Temporomandibular Joint Disorders in
the Short- and Long-Term? J Oral Maxillofac Surg [Internet]
2020; 78(1):44-51. Disponível em URL: https://doi.
org/10.1016/j.joms.2019.07.011.
8. Haeffs TH, D’Amato LN, Khawaja SN, Keith DA, Scrivani
SJ. What Variables Are Associated With the Outcome of Arthroscopic
Lysis and Lavage Surgery for Internal Derangement
of the Temporomandibular Joint? J Oral Maxillofac
Surg [Internet] 2018; 76(10):2081-8. Disponível em URL:
https://doi.org/10.1016/j.joms.2018.04.018.
9. Efeoglu C, Calis AS, Koca H, Yuksel E. A stepped approach
for the management of symptomatic internal derangement
of the temporomandibular joint. J Otolaryngol - Head Neck
Surg 2018; 47(1):1-7. Disponível em URL: https://doi.org/
10.1186 / s40463-018-0282-y.
10. Fernández Sanromán J, Fernández Ferro M, Costas López
A, Arenaz Bua J, López A. Does injection of plasma rich in
growth factors after temporomandibular joint arthroscopy
improve outcomes in patients with Wilkes stage IV internal
derangement? A randomized prospective clinical study. Int
J Oral Maxillofac Surg 2016; 45(7):828-35. Disponível em
URL: https://doi.org/10.1016 / j.ijom.2016.01.018.
11. Abboud W, Nadel S, Yarom N, Yahalom R. Arthroscopy of the
temporomandibular joint for the treatment of chronic closed
lock. Isr Med Assoc J 2016; 18(7):397-400. Disponível em
URL: https://pubmed.ncbi.nlm.nih.gov/28471560/.
12. Sato FRL, Lima CAA, Tralli G, da Silva RA. Is there a correlation
between arthroscopic findings and the clinical signs
and symptoms of patients with internal derangement of the
temporomandibular joint? A prospective study. Int J Oral
Maxillofac Surg [Internet] 2019; 48(2):233-8. Disponível em
URL: https://doi.org/10.1016/j.ijom.2018.07.004.
13. Lee LM, Zhu YM, Zhang D Di, Deng YQ, Gu Y. Synovial
Chondromatosis of the Temporomandibular Joint: A clinical
and arthroscopic study of 16 cases. J Cranio-Maxillofacial
Surg [Internet] 2019; 47(4):607-10. Disponível em URL:
https://doi.org/10.1016/j.jcms.2019.02.003.
14. Dimitroulis G. Outcomes of temporomandibular joint
arthroscopy in patients with painful but otherwise normal
joints. J Cranio-Maxillofacial Surg [Internet] 2015;
43(6):940-3. Disponível em URL: http://dx.doi.org/10.1016/j.
jcms.2015.03.035.
15. González-García R, Moreno-Sánchez M, Moreno-García C,
Román-Romero L, Monje F. Arthroscopy of the Inferior Compartment
of the Temporomandibular Joint: a New Perspective.
J Maxillofac Oral Surg 2018; 17(2):228-32. Disponível
em URL: https://doi.org/ 10.1007 / s12663-017-1023-x.
16. Breik O, Devrukhkar V, Dimitroulis G. Temporomandibular
joint (TMJ) arthroscopic lysis and lavage: Outcomes and rate
of progression to open surgery. J Cranio-Maxillofacial Surg
[Internet] 2016; 44(12):1988-95. Disponível em URL: http://
dx.doi.org/10.1016/j.jcms.2016.09.017.
17. Martin Granizo R, Correa Muñoz DC, Varela Reyes E. Rearthroscopy
of the temporomandibular joint: A retrospective
study of 600 arthroscopies. J Cranio-Maxillofacial Surg [Internet]
2018; 46(9):1555-60. Disponível em URL: https://doi.
org/10.1016/j.jcms.2017.12.007.
18. Muñoz-Guerra MF, Rodríguez-Campo FJ, Escorial-Hernández
V, Brabyn PJ, Fernández-Domínguez M, Naval-Gías L.
The minimally invasive arthroscopic anterior myotomy in
the treatment of internal derangement of the temporomandibular
joint. A detailed description of the surgical technique.
J Stomatol Oral Maxillofac Surg 2020. Disponível em URL:
https://doi.org/ 10.1016 / j.jormas.2020.04.006.
19. Pastore GP, Goulart DR, Pastore PR, Prati AJ. Removal
of a solitary synovial chondromatosis of the temporomandibular
joint using arthroscopy. J Craniofac Surg 2016;
27(4):967-9. Disponível em URL: https://doi.org/10.1097/
SCS.0000000000002612.
20. Bai G, Yang C, Qiu Y, Chen M. Open surgery assisted with
arthroscopy to treat synovial chondromatosis of the temporomandibular
joint. Int J Oral Maxillofac Surg [Internet] 2017;
46(2):208-13. Disponível em URL: http://dx.doi.org/10.1016/j.
ijom.2016.09.010.
21. Laviv A, Sadow PM, Keith DA. Pseudogout in the temporomandibular
joint with imaging, arthroscopic, operative, and
pathologic findings. Report of an unusual case. J Oral Maxillofac
Surg 2015; 73(6):1106-12. Disponível em URL: https://
doi.org/ 10.1016 / j.joms.2014.12.041.
22. Cariati P, Garcia Medina B, Galvez P, Cabello Serrano A,
Garcia Martin M, Valencia Moya G. Arthroscopic Eminoplasty
of Temporomandibular Joint: Surgical Technique. Craniomaxillofac
Trauma Reconstr 2018; 11(2):161-4. Disponível
em URL: https://doi.org/ 10.1055 / s-0038-1639349.
23. Martín-Granizo R. Simple and secure intra-articular infiltration
during arthroscopy of the temporomandibular joint. Br J
Oral Maxillofac Surg [Internet] 2018; 56(8):763-5. Disponível
em URL: https://doi.org/10.1016/j.bjoms.2018.07.004.
24. Martín-Granizo R, Maniegas L, Colorado L, Millon-Cruz A,
de Pedro M. Direct infiltration of botulinum toxin into the
pterygoid lateral muscle for repositioning of the disc during
arthroscopy of the temporomandibular joint. Br J Oral Maxillofac
Surg 2018; 56(8):769-71. Disponível em URL: https://
doi.org/10.1016/ j.bjoms.2018.07.014.
25. Hossameldin RH, McCain JP. Outcomes of office-based
temporomandibular joint arthroscopy: a 5-year retrospective
study. Int J Oral Maxillofac Surg [Internet] 2018;
47(1):90-7. Disponível em URL: http://dx.doi.org/10.1016/j.
ijom.2017.06.025.
26. Fernández Sanromán J, Costas López A, Fernández Ferro
M, de Sánchez AL, Stavaru B, Arenaz Bua J. Complications
of temporomandibular joint arthroscopy using twoportal
coblation technologies: a prospective study of 475
procedures. J Cranio-Maxillofacial Surg [Internet] 2016;
44(9):1221-5. Disponível em URL: http://dx.doi.org/10.1016/j.
jcms.2016.06.027.
27. Al-Moraissi EA. Open versus arthroscopic surgery for the
management of internal derangement of the temporomandibular
joint: a meta-analysis of the literature. Int J Oral
Maxillofac Surg [Internet] 2015; 44(6):763-70. Disponível em
URL: http://dx.doi.org/10.1016/j.ijom.2015.01.024.
28. Leonardi R, Crimi S, Almeida LE, Pannone G, Musumeci G,
Castorina S, et al. ADAMTS-4 and ADAMTS-5 expression
in human temporomandibular joint discs with internal derangement,
correlates with degeneration. J Oral Pathol Med
2015; 44(10):870-5.
29. American Society of Temporomandibular Joint Surgeons.
Guidelines for diagnosis and management of disorders involving
the temporomandibular joint and related musculoskeletal
structures. American Society of Temporomandibular
Joint Surgeons. Northwest Dent 2005; 71(5):21-7.
30. Cho J, Israel H. Does the Age of a Patient Affect the Outcome
of Temporomandibular Joint Arthroscopic Surgery? J Oral
Maxillofac Surg [Internet] 2017; 75(6):1144-50. Disponível
em URL: http://dx.doi.org/10.1016/j.joms.2016.10.038.
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How to Cite
The use of arthroscopy for the diagnosis and treatment of internal temporomandibular joint disorders. (2021). Revista Da Faculdade De Odontologia - UPF, 25(3), 333-338. https://doi.org/10.5335/rfo.v25i3.11619
