title: Arthroscopy versus arthrocentesis. A retrospective study of disc displacement management without reduction.
abstract: OBJECTIVE
  To compare the outcome of arthroscopic surgery and arthrocentesis of internal derangement (disc displacement without reduction) of the temporomandibular joint (TMJ).
  
  
  METHODS
  The charts of 48 patients with TMJ derangement and treated with arthroscopy or arthrocentesis were included in this study carried out in a specialized private clinic in Beirut, Lebanon, between January 2001 and July 2005. Inclusion criteria included patients with a history of clicking followed by a sudden onset of limited mouth opening without clicking, a complaint of TMJ pain with mouth opening or chewing difficulty, or both, or a positive magnetic resonance imaging diagnosis of TMJ disc displacement without reduction. Patients with limited mouth opening caused by only muscle spasm, prior TMJ surgery, bilateral joint involvement, or serious systemic diseases were excluded from the study. Twenty-eight patients underwent arthroscopy (group one) and 20 patients were treated with arthrocentesis (group 2).
  
  
  RESULTS
  Both methods showed a significant reduction in pain and an increase in maximal mouth opening on follow up (p<0.01). There was no statistical difference between the methods.
  
  
  CONCLUSIONS
  Further research should be conducted before one can definitely determine if real benefits are achieved through surgery in TMJ articular disorders. Within the limits of this study, less invasive procedures are highly recommended.
authors.affiliation: Department of Prosthodontics and Occlusion, School of Dental Medicine, Riyadh, Kingdom of Saudi Arabia.
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Hobeich
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Salameh
authors.forename: Eman
authors.initials: E
authors.lastname: Ismail
authors.forename: Walid M
authors.initials: WM
authors.lastname: Sadig
authors.forename: Nabil E
authors.initials: NE
authors.lastname: Hokayem
authors.forename: Khalid
authors.initials: K
authors.lastname: Almas
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D012189:Retrospective Studies; D019224:Temporomandibular Joint Disc; D016896:Treatment Outcome