Prospective multicenter comparison of 4 temporomandibular joint operations.
OBJECTIVE
This study was designed to compare the outcomes of 4 operations used for the treatment of painful temporomandibular joints with an internal derangement.


METHODS
A prospective, controlled study of arthroscopy, condylotomy, discectomy, and disc repositioning was conducted at 3 sites. All sites used the same inclusion and exclusion criteria. Trained, independent examiners assessed pain, diet, and range of motion before operation and 1 month and 1 year after operation.


RESULTS
There were statistically significant reductions in the amount of pain ( P < .001) and daily time in pain ( P < .001) that were similar for all 4 operations 1 month and 1 year after the procedures. The degrees of change after each of the 4 procedures were not statistically different from each other (amount: P = .453 and time: P = .416). Ability to chew, as measured by diet visual analog scale, was substantially improved 1 year after operation ( P < .001). The degrees of change for diet at 1 year also were not different from each other ( P = .314). There were, however, statistically significant differences ( P < .05) in range of motion that varied with procedure.


CONCLUSIONS
All 4 operations were followed by marked improvements in pain and diet. The amounts of improvement varied slightly by operation, but these differences were not statistically significant. There were small but statistically significant differences between procedures for range of motion. If these findings are confirmed, they have an important implication for procedure selection.
Hall
H David
HD
Department of Oral and Maxillofacial Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Indresano
A Thomas
AT
Kirk
William S
WS
Dietrich
Mary S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D004032:Diet; D005157:Facial Pain / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D053685:Laser Therapy; D008297:Male; D008335:Mandibular Condyle / Q000601:surgery; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D020247:Myofunctional Therapy; D017090:Occlusal Splints; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D019224:Temporomandibular Joint Disc / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome