Surgical treatment of intracapsular temporomandibular disorders

Authors

  • Bailing Chen Muping District Traditional Chinese Medicine Hospital, Yantai, China
  • Xinhua Qu GYN Department, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China

DOI:

https://doi.org/10.2340/aos.v83.40633

Keywords:

Pathology, temporomandibular joint, surgical methods, conservative methods, functional disorders

Abstract

Objective: Temporomandibular joint (TMJ) pathologies are prevalent, affecting approximately 40% of the worldwide population, with nearly 80% involving intracapsular disorders. Despite this, standardized treatment protocols are lacking. This study aimed to compare the efficacy of conservative and surgical approaches in managing intracapsular TMJ disorders.

Methods: Eighty-six patients diagnosed with intracapsular TMJ disorders were included in the study, with 40 males and 46 females, averaging 52.4 ± 4.7 years. Patients were recruited from polyclinics in Beijing, China (n = 36), and Kyiv, Ukraine (n = 50). A comprehensive examination protocol was conducted, including assessment of patient complaints, medical history, jaw mobility measurements, TMJ palpation, and magnetic resonance imaging (MRI) screening.

Results: The main outcomes of our study revealed significant improvements in patients undergoing surgical intervention for intracapsular TMJ disorders, particularly in cases of disc displacement. Conservative mouth guard/occlusal splint treatment showed limited effectiveness, primarily improving joint effusion and disc displacement. Surgical intervention led to notable enhancements in various TMJ parameters, with significant improvements observed in joint function and pain reduction. Based on these findings, orthodontic rehabilitation was recommended to ensure long-term efficacy, focusing on optimizing occlusion and restoring TMJ function. These results highlight the importance of tailored treatment approaches for managing intracapsular TMJ disorders, emphasizing the role of surgical intervention coupled with comprehensive rehabilitation strategies.

Conclusions: Future research should consider demographic factors and explore innovative examination methods, such as optical systems, to enhance understanding and management of intracapsular TMJ disorders.

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References

Ferrillo M, Nucci L, Giudice A, et al. Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis. Milano: Cranio; 2022. DOI: https://doi.org/10.1080/08869634.2022.2126079

Lyashev IN, Dybov AM, Kholmogorova PV. The effectiveness of the surgical correction of the temporomandibular joint intracapsular disorders. J Clin Pract. 2019;10(2):6–13. https://doi.org/10.17816/clinpract1026-13 DOI: https://doi.org/10.17816/clinpract1026-13

Kostiuk TM, Kaniura AA, Lytovchenko N. Analysis of efficiency of the temporo-mandibular disorders treatment. Med Sci Ukraine (MSU). 2020;16(1):48–51. https://doi.org/10.32345/2664-4738.1.2020.07 DOI: https://doi.org/10.32345/2664-4738.1.2020.07

Henein P, Ziccardi VB. Temporomandibular disorders: surgical implications and management. Dent Clin North Am. 2023;67(2):349–365. https://doi.org/10.1016/j.cden.2022.12.002 DOI: https://doi.org/10.1016/j.cden.2022.12.002

Shakya S, Li KD, Huang D, et al. Mini suture anchor: an effective device for reduction and fixation of displaced temporomandibular joint disc with intracapsular condylar fracture. Chin J Traumatol. 2022;25(1):49–53. https://doi.org/10.1016/j.cjtee.2021.08.009 DOI: https://doi.org/10.1016/j.cjtee.2021.08.009

De Nordenflycht D, Matus G, Aravena JP, et al. Osteochondritis dissecans of the temporomandibular joint: a scoping review. Oral Maxillofac Surg. 2023;28;29–38. https://doi.org/10.1007/s10006-022-01134-2 DOI: https://doi.org/10.1007/s10006-022-01134-2

Silva RG, Connelly ST, Holman KA. Modern temporomandibular joint surgery: a review. J Calif Dent Assoc. 2021;49(3):137–147. https://doi.org/10.1080/19424396.2021.12222683 DOI: https://doi.org/10.1080/19424396.2021.12222683

Ren R, Dai J, Zhi Y, et al. Comparison of temporomandibular joint function and morphology after surgical and non-surgical treatment in adult condylar head fractures. J Craniomaxillofac Surg. 2020;48(3):323–330. https://doi.org/10.1016/j.jcms.2020.01.019 DOI: https://doi.org/10.1016/j.jcms.2020.01.019

Opris H, Baciut M, Bran S, et al. Lateral cephalometric analytical uses for temporomandibular joint disorders: the importance of cervical posture and hyoid position. Int J Environ Res Public Health. 2022;19(17):11077. https://doi.org/10.3390/ijerph191711077 DOI: https://doi.org/10.3390/ijerph191711077

Shastry SP, Susainathan A, Young A, et al. Nerve blocks and interventional procedures in the management of temporomandibular joint disorders: a scoping review. J Oral Maxillofac Anesth. 2022;1:28. https://doi.org/10.21037/joma-22-9 DOI: https://doi.org/10.21037/joma-22-9

Al-Ani Z. Temporomandibular joint osteoarthrosis: a review of clinical aspects and management. Prim Dent J. 2021;10(1):132–140. https://doi.org/10.1177/2050168420980977 DOI: https://doi.org/10.1177/2050168420980977

Somay E, Yilmaz B. Arthrocentesis treatment in temporomandibular joint disc displacement without reduction: a review of the literature. In: Berhardt LV, editor. Advances in medicine and biology. New York, NY: Nova Science Publishers, Inc.; 2021, pp. 93–123.

Almubarak SM, Ashour LM, Aleissa ZH, et al. Current concepts about temporomandibular joint disorders: a review. J Res Med Dent Sci. 2020;8(7):471–479.

Covert L, Mater HV, Hechler BL. Comprehensive management of rheumatic diseases affecting the temporomandibular joint. Diagnostics (Basel). 2021;11(3):409. https://doi.org/10.3390/diagnostics11030409 DOI: https://doi.org/10.3390/diagnostics11030409

Rodhen RM, de Holanda TA, Barbon FJ, et al. Invasive surgical procedures for the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis regarding the effects on pain and jaw mobility. Clin Oral Investig. 2022;26(4):3429–3446. https://doi.org/10.1007/s00784-022-04428-7 DOI: https://doi.org/10.1007/s00784-022-04428-7

Rechtin M, Krishnan DG. A decade of complications following total Temporomandibular Joint Reconstruction (TJR) in a patient with ehlers-danlos syndrome. Another surgical misadventure or an absolute contraindication for TJR? J Oral Maxillofac Surg. 2021;79(10):2059.e1–2059.e5. https://doi.org/10.1016/j.joms.2021.05.016 DOI: https://doi.org/10.1016/j.joms.2021.05.016

Ricardo F, Moleirinho-Alves P, Cebola P, et al. Strategies to manage anterior disc displacement without reduction of temporomandibular joint: A case report. Ann Med. 2021;53(Suppl 1):S156. https://doi.org/10.1080/07853890.2021.1896838 DOI: https://doi.org/10.1080/07853890.2021.1896838

Zhang Y, He DM. Clinical investigation of early post-traumatic temporomandibular joint ankylosis and the role of repositioning discs in treatment. Int J Oral Maxillofac Surg. 2006;35(12):1096–1101. https://doi.org/10.1016/j.ijom.2006.09.003 DOI: https://doi.org/10.1016/j.ijom.2006.09.003

Obraztsova NA, Samsonov AA, Kovtunenko MA, et al. Influence of excipients and pressing force on the impurity content of N-(4-aminobenzoyl)-L-glutamic acid in folic acid drugs during storage. Drug Dev Registr. 2023;12(2):55–60. https://doi.org/10.33380/2305-2066-2023-12-2-55-60 DOI: https://doi.org/10.33380/2305-2066-2023-12-2-55-60

Semina II, Baichurina AZ, Nikitin DO, et al. Behavioral pharmacology as the main approach to study the efficiency of potential psychotropic drugs: analysis of modern methods (review). Drug Dev Registr. 2023;12(1):161–181. https://doi.org/10.33380/2305-2066-2023-12-1-161-181 DOI: https://doi.org/10.33380/2305-2066-2023-12-1-161-181

Bhattacharjee B, Bera RN, Verma A, et al. Efficacy of arthrocentesis and stabilization splints in treatment of temporomandibular joint disc displacement disorder without reduction: a systematic review and meta-analysis. J Maxillofac Oral Surg. 2023;22(1):83–93. https://doi.org/10.1007/s12663-021-01675-1 DOI: https://doi.org/10.1007/s12663-021-01675-1

Poluha RL, Canales GT, Costa YM, et al. Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. J Appl Oral Sci. 2019;27:e20180433. https://doi.org/10.1590/1678-7757-2018-0433 DOI: https://doi.org/10.1590/1678-7757-2018-0433

Pai SA, Poojari SR, Ramachandra K, et al. Temporomandibular joint disorders-Part II. J Adv Clin Res Insights. 2019;6(1):11–13. https://doi.org/10.15713/ins.jcri.249 DOI: https://doi.org/10.15713/ins.jcri.249

Chung PY, Lin MT, Chang HP. Effectiveness of platelet-rich plasma injection in patients with temporomandibular joint osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127(2):106–116. https://doi.org/10.1016/j.oooo.2018.09.003 DOI: https://doi.org/10.1016/j.oooo.2018.09.003

Polat ME, Yanik S. Efficiency of arthrocentesis treatment for different temporomandibular joint disorders. Int J Oral Maxillofac Surg. 2020;49(5):621–627. https://doi.org/10.1016/j.ijom.2019.08.017 DOI: https://doi.org/10.1016/j.ijom.2019.08.017

Chavan A, Toshniwal NG, Manerikar R, et al. Evidence based management protocol in temporomandibular joint disorders: a current and compendious update. In: Jain S, editor. Self reliant India-A pathway to developed India mission 2030 (return of golden era). Panagar, MP: Black Pearl Publication; 2021, pp. 47–58.

Chu ECP, Spaska A, Monov D, et al. Examining the correlation between salivary cytokine concentrations and CRP in people experiencing social-cognitive stress. Neurol Res. 2023;45(2):160–165. https://doi.org/10.1080/01616412.2022.2126681 DOI: https://doi.org/10.1080/01616412.2022.2126681

Grishin A, Spaska A, Kayumova L. Correction of overactive bladder with botulinum toxin type A (BTX-A). Toxicon. 2021;200:96–101. https://doi.org/10.1016/j.toxicon.2021.07.005 DOI: https://doi.org/10.1016/j.toxicon.2021.07.005

Kumar MSP, Murugesan K, Hinaz N. Surgical treatment modalities in the management of temporomandibular joint disorders. Int J Dentistry Oral Sci. 2021;8(9):4168–4179. https://doi.org/10.19070/2377-8075-21000852 DOI: https://doi.org/10.19070/2377-8075-21000852

Published

2024-05-07