title: Correlation between preoperative mouth opening and surgical outcome after arthroscopic lysis and lavage in patients with disc displacement without reduction.
abstract: OBJECTIVE
  This study was designed to evaluate the efficacy of arthroscopic lysis and lavage for patients with limited mouth opening. The relationship between preoperative mouth opening and the surgical outcome was determined.
  
  
  METHODS
  Fourteen patients with 16 internally deranged joints were treated by arthroscopic lysis and lavage. All had received 10.4 (7 to 19) months of nonsurgical treatment before arthroscopy. The preoperative magnetic resonance images showed anterior disc displacement without reduction in all treated joints.
  
  
  RESULTS
  Twelve of the 14 patients (86%) showed good reduction in pain and improved range of jaw movement on average follow-up of 28.5 (13 to 66) months. Two patients showed no improvement after arthroscopy and required open surgical procedures. The preoperative mouth opening of the successful group averaged 29.4 (22 to 35) mm, whereas the two failed cases had 10- and 19-mm openings, respectively (P < .05).
  
  
  CONCLUSIONS
  Persistent limitation of mouth opening of more than 22 mm after nonsurgical treatment has a good prognosis when treated by arthroscopic lysis and lavage. However, those with greater limitation should probably have earlier surgical intervention.
authors.affiliation: The First Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kurita
authors.forename: A N
authors.initials: AN
authors.lastname: Goss
authors.forename: N
authors.initials: N
authors.lastname: Ogi
authors.forename: M
authors.initials: M
authors.lastname: Toyama
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016059:Range of Motion, Articular; D019224:Temporomandibular Joint Disc / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000601:surgery*; D007507:Therapeutic Irrigation; D000267:Tissue Adhesions / Q000601:surgery; D017211:Treatment Failure