Discectomy without replacement for the treatment of painful reciprocal clicking or catching and chronic closed lock of the temporomandibular joint: a clinical follow-up audit

作者：Holmlund Anders^*; Lund Bodil; Weiner Carina Kruger

来源：British Journal of Oral and Maxillofacial Surgery, 2013, 51(8): E211-E214.

DOI：10.1016/j.bjoms.2012.12.006

• TMJ
• Discectomy
• Reciprocal clicking
• Chronic closed lock

Our main aim was to find out if the outcome after temporomandibular joint (TMJ) discectomy differed between patients diagnosed with chronic closed lock and those with reciprocal clicking. A further aim was to identify factors that could have an adverse influence on the outcome of discectomy. The study was designed as a prospective, clinical, follow-up audit. A total of 51 patients were included, 24 diagnosed with closed lock and 27 with reciprocal clicking. All patients had a TMJ discectomy and were followed up for 6 months. The treatment was regarded as successful when the maximal interincisal opening postoperatively was 35mm or more, and the subjective scoring of functional impairment and pain (rated on a 10-point visual analogue scale) showed at least 40% improvement or was rated less than 4. Both groups showed significant improvements (p < 0.0001). There was a significant difference in outcome only for pain between the 2 groups using our criteria for success. An unsuccessful outcome seems to correlate with chronic closed lock without preceding clicking and a previous unsuccessful arthroscopy. Discectomy seems to be a good choice of treatment for patients with reciprocal clicking or chronic closed lock of the TMJ, and is associated with a low incidence of complications.

• 出版日期2013-12