Discectomy as the primary surgical option for internal derangement of the temporomandibular joint.
OBJECTIVE
The goal of this study was to evaluate outcomes of patients who underwent temporomandibular joint (TMJ) discectomy without replacement as the primary treatment for internal derangement after failure of nonsurgical therapy.


METHODS
Thirty consecutive patients with TMJ internal derangement were treated with discectomy from 2001 to 2007. Four patients were lost to follow-up, and 2 were excluded because of prior joint surgery. Using the standardized Helkimo Anamnestic and Clinical Dysfunction Indexes, 24 patients, or 32 joint surgeries, were evaluated postoperatively, with an average follow-up of 30.8 months (range, 2 to 60 months).


RESULTS
All 24 patients showed improvement in mandibular mobility and joint function, as well as reduction in TMJ and muscular facial pain, represented by a clinical dysfunction index of DiO, DiI, or DiII. Preoperatively, all patients had an anamnestic index of AiII, which represented moderate to severe pain in the TMJ and masticatory muscles, and/or locking of the joint before surgery. Postsurgically, 20 of the 24 patients scored an index of DiO or DiI, which correlated with a clinically symptom-free state or only a small, minor dysfunction. TMJ pain, muscle pain, and pain with mobility scored the lowest point index, indicating a subjectively successful outcome.


CONCLUSIONS
Discectomy of the TMJ as a primary surgical option significantly reduces pain and improves function.
Miloro
Michael
M
Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago College of Dentistry, Chicago, IL 60612-7211, USA. mmiloro@uic.edu
Henriksen
Brent
B
D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D005157:Facial Pain / Q000601:surgery; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D019224:Temporomandibular Joint Disc / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult