Arthroscopic laser surgery in temporomandibular functional joint disorders.
OBJECTIVE
The authors present the 1-year results of combined use of arthroscopic lysis and lavage procedure, capsular stretch and holmium:yttrium-aluminium-garnet (Ho:YAG) laser techniques for the treatment of chronic closed lock of the temporomandibular joint.


METHODS
Twelve joints were treated in 10 patients (9 females and 1 male) affected by anterior disk displacement without reduction not responsive to conservative treatment. All the patients were studied with preoperative magnetic resonance immaging (MRI). Surgical procedures included lysis and lavage, capsular stretch and Ho:YAG laser techniques with anterior release, posterior scarification and debridment of cartilage surface. The individual outcome was evaluated with the clinical examination, a visual analogue scale (VAS) for pain and a questionnaire concerning mandibular functional impairment. Patients were followed-up for 1 year.


RESULTS
One-year results show that 9 patients (success rate 90%) achieved improvement of mandibular function and reduction of pain. The clinical recordings at the 1-year follow-up indicated good outcomes. Nine patients could masticate a regular diet at 1-year follow-up.


CONCLUSIONS
These findings seem to justify the use of Ho:YAG laser techniques together with the lysis and lavage procedure and capsular stretch for the treatment of chronic closed lock of the temporomandibular joint. These arthroscopic procedures represent the first choice and an effective approach in the surgical treatment of this condition.
Politi
M
M
Department of Maxillofacial Surgery, Faculty of Medicine, University of Udine, Udine, Italy. m.politi@med.uniud.it
Sembronio
S
S
Albiero
A M
AM
Costa
F
F
Robiony
M
M
Undt
G
G
D001182:Arthroscopy; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*