Use of Coblation in arthroscopic surgery of the temporomandibular joint.
OBJECTIVE
To evaluate the effectiveness of Coblation in temporomandibular joint (TMJ) arthroscopic surgeries and to preliminarily evaluate the clinical effects.


METHODS
Arthroscopic Coblation, combined with disc suturing, was performed in 419 TMJs from July 2001 to March 2007 by use of the ArthroCare System 2000 radiofrequency machine (ArthroCare, Sunnyvale, CA). All patients had stage II to V internal derangement, according to the classification of Wilkes. Besides disc suturing, the technique of Coblation was used in procedures of adhesion ablation, anterior release, chondroplasty, and discoplasty. All patients were followed up for 3 months and evaluated based on immediate arthroscopic findings, by clinical examination, and by magnetic resonance imaging examination.


RESULTS
During the TMJ arthroscopic surgeries, the adhesion, unhealthy disc, and cartilage were ablated completely. The surface of the cartilage and disc were smooth without cautery damage and hemorrhage. During the clinical follow-up period, 76.37% of TMJs (320/419) had excellent results and 16.47% (69/419) had good results. The success rate was 92.84%. Masseter muscle atrophy occurred in 4 patients, and 30 TMJs required second arthroscopic surgeries or open surgeries.


CONCLUSIONS
The technique of Coblation has proved to be an effective and minimally invasive option for the treatment of TMJ internal derangement, with advantages such as offering a high degree of precision and control, causing little or no thermal damage to surrounding tissue, leaving smooth anatomic surfaces, and achieving hemostasis of smaller blood vessels.
Chen
Min Jie
MJ
Department of Oral and Maxillofacial Surgery, School of Stomatology, Shanghai Ninth People's Hospital, and School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Yang
Chi
C
Zhang
Shan Yong
SY
Cai
Xie Yi
XY
D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods*; D003080:Cold Temperature; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011846:Radio Waves; D013704:Temporomandibular Joint / Q000601:surgery*; D019224:Temporomandibular Joint Disc / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery*; D000267:Tissue Adhesions / Q000601:surgery; D055815:Young Adult