Open versus arthroscopic surgery for internal derangement of the temporomandibular joint: a retrospective study comparing two centres' results using the Jaw Pain and Function Questionnaire.
OBJECTIVE
Surgical procedures currently used for treating of internal derangement of the temporomandibular joint vary widely. Although different studies present favourable results following open or arthroscopic TMJ surgery, the criteria for a successful treatment outcome are not always defined identically. In a retrospective study, two groups of patients who underwent either open or arthroscopic surgery for internal derangement (stages III-V according to Wilkes' classification) were investigated using the so-called JPF-Questionnaire.


METHODS
The Kyoto collective (group 1) consisted of 28 patients, 2 men and 26 women, who underwent arthroscopic surgery. At the time of surgery, age ranged from 13 to 77 years (mean 32.8 y). The postoperative follow-up period ranged from 4 years and 4 months to 5 years and 9 months. Twelve of the 28 patients were classified as stage III, 10 as stage IV and 6 were classified as stage V (according to Wilkes) at the time of surgery. The Vienna collective (group 2) also consisted of 28 patients, 2 men and 26 women, who underwent open meniscoplasty or discectomy. At the time of surgery age ranged from 17 to 55 years (mean 31.6 years). The postoperative follow-up ranged from 5 to 6 years and 9 months. Fourteen of the 28 patients were classified as stage III, 11 as stage IV and 3 were classified as stage V (according to Wilkes) at the time of surgery. The results of the JPF-Questionnaire of the two groups were compared by Wilcoxon 2-sample tests. The Japanese version was applied, while in Austria the German version of this questionnaire was applied.


RESULTS
At a level of significance alpha=0.05 no significant difference was found when comparing the subgroups (Wilkes stages III, IV and V) or both groups of patients 5 years after temporomandibular joint surgery.


CONCLUSIONS
There cannot be any clear indication for only one of the treatment modalities as similar results were noted following open or arthroscopic temporomandibular joint surgery. Nevertheless, arthroscopic surgery is a minimally invasive procedure resulting in a shorter or no time of hospitalization when compared with open surgery and therefore is preferred by many surgeons nowadays.
Undt
Gerhard
G
Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Austria. gerhard.undt@meduniwien.ac.at
Murakami
Ken-Ichiro
K
Rasse
Michael
M
Ewers
Rolf
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D001317:Austria; D005157:Facial Pain / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013704:Temporomandibular Joint / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000473:pathology / Q000601:surgery*