New Arthroscopic Disc Repositioning and Suturing Technique for Treating Internal Derangement of the Temporomandibular Joint: Part II-Magnetic Resonance Imaging Evaluation

作者:Zhang, Shan-Yong; Liu, Xiu-Ming; Yang, Chi*; Cai, Xie-Yi; Chen, Min-Fie; Haddad, Majd S.; Yun, Bai; Chen, Zhuo-Zhi
来源:Journal of Oral and Maxillofacial Surgery, 2010, 68(8): 1813-1817.
DOI:10.1016/j.joms.2009.08.012

摘要

Purpose: To evaluate the efficiency of an arthroscopic suturing technique for stabilizing anteriorly displaced discs in patients with internal derangement of the temporomandibular joint (TMJ) by magnetic resonance (MR) imaging. @@@ Patients and Methods: Six hundred thirty-nine patients (764 joints) diagnosed as having stages II to V of internal derangement were treated with arthroscopic disc repositioning and suturing from August 2004 to March 2007. Consecutive MR images were used to evaluate internal derangement before and approximately 1 to 7 days after the operation for all 639 patients. The disc position of the TMJ was judged according to the success criteria, which included 3 different sagittal planes (lateral, central, and medial). Operative efficiency in those patients, whose discs of the TMJ were affirmed to be in a normal position in all 3 planes, was evaluated to be excellent. Those patients whose discs were in a normal position in 2 planes were evaluated to be good. The others were evaluated to be poor. Cases evaluated as excellent and good were considered success cases (if the disc is displaced only in 1 or 2 planes before operation, the efficiency of the operation would be evaluated as a success only if the whole disc was in normal position). @@@ Results: Postoperative consecutive MR images for all 764 joints confirmed that 95.42% (729/764) of the joints were excellent, 3.14% (24/764) were good, and only 1.44% (11/764) were poor. Repeated arthroscopic surgery or open surgery was carried out for the joints that were evaluated as poor. @@@ Conclusion: This study indicates that the TMJ arthroscopic suturing technique is effective in repositioning the TMJ disc as confirmed by an MR imaging examination, but long-term follow-up is necessary.