Pterygoid dysjunction: new minimally invasive technique for the treatment of painful temporomandibular joint dysfunction.
OBJECTIVE
To evaluate the efficacy of pterygoid dysjunction for the surgical management of temporomandibular joint (TMJ) pain and dysfunction.


METHODS
This study was composed of 10 patients (20 joints), of whom 2 patients had bilateral joint pain. Patients were those who complained of TMJ pain and dysfunction with mild to moderate internal derangement and who have failed to respond to all methods of conservative management. Only patients whose complaints of pain were confined to the pterygoid muscles on palpation were considered for this study. Clinical examination included pain and tenderness in relation to joint, muscles of mastication, movement of joint, and abnormal joint noises.


METHODS
Under general anesthesia, pterygomaxillary dysjunction was done bilaterally, the pterygoid plates were pushed backward, and the outcome was evaluated using computed tomography.


RESULTS
Immediately after operation, most patients were free from pain, and the intensity of pain was reduced in the rest of the patients. There was progressive improvement of mouth opening, and clicking was reduced in most of the patients in the late postoperative phase. Follow-up and regular counseling were done for 2 years. Clicking and mouth opening have considerable significance, but all patients were free from pain and were comfortable, except for some patients who have simple complaints, which are irrelevant to this study.


CONCLUSIONS
Although the total number of patients was too small to arrive at any definitive conclusion, the encouraging results, especially the relief from pain, show that this technique has a significant role in the treatment of painful TMJ dysfunction, with mild to moderate internal derangement, and is devoid of other major complications.
Kannan
Sadesh V
SV
Department of Oral and Maxillofacial Surgery, Karpaga Vinayaga Institute of Dental Sciences, Chennai, India. sadeshkannan@yahoo.co.in
D000328:Adult; D003376:Counseling; D005157:Facial Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D010147:Pain Measurement; D011626:Pterygoid Muscles / Q000503:physiopathology* / Q000601:surgery*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome