Inside the joint: redefining the role of minimally invasive surgery for temporomandibular joint disorders
Inside the joint: redefining the role of minimally invasive surgery for temporomandibular joint disorders
Degenerative disorders of the jaw joint can cause pain, limited mouth opening and may severely impact daily functioning. Treatment usually starts with conservative options such as physiotherapy, a dental splint and medication. These aim to reduce pain and maintain joint function. If these treatments are insufficient, minimally invasive surgery may be performed. One option is arthrocentesis, where the joint is flushed to remove inflammatory substances and support recovery. Another is arthroscopy, where a small camera is used to examine and treat the joint, while simultaneously flushing it.
This research Yang Hang Tang shows that arthrocentesis reduces pain more effectively than conservative treatments and that starting arthrocentesis early (preferably within 6 months) may increase chances of recovery.
It remains unclear whether arthrocentesis or arthroscopy is the most effective minimally invasive surgical treatment. Previous studies show similar outcomes for pain relief and function recovery, but the quality of this evidence is limited. If both treatments are equally effective, arthrocentesis may be preferred because it is simpler and less costly. However, in this thesis the first high-quality study comparing these treatments suggests that arthroscopy is more effective in reducing pain, although findings are not yet definitive.
Lastly, if the first minimally invasive treatment does not work, a second treatment can still be successful. However, repeated treatments become less effective over time.
Overall, timely treatment and choosing the right approach for each patient are important. Future research should aim to better predict which treatment works best for which patients.