Temporomandibular joint surgery.

Abstract

Rapid progress has been made in the field of temporomandibular joint (TMJ) surgery during the past decade. These developments are predominantly due to the ongoing refinement of imaging and operative techniques. Parallel to these changes, the new techniques of arthroscopic surgery have been introduced into standard therapy for internal derangement and osteoarthrosis, to some extent. Several earlier studies have shown that open and arthroscopic surgery have similar success rates. Therefore, the surgeon has to decide which method would combine the smallest risk of postoperative morbidity with the least operative effort. In this regard, arthrocentesis is inaugurated as a new operative method for treatment of the closed lock. However, the basic concepts of arthroscopic surgery seem to be contradictory to the concepts of open surgery, which have also been proven successfully. Thus, the success of arthroscopic methods challenges our understanding of the pathogenesis and pathophysiology of internal derangements and osteoarthrosis of the TMJ. Today, morphologic findings from either arthroscopy, magnetic resonance imaging and new findings in the field of joint physiology lead to plausible explanations for the etiology and symptomatology of internal derangements. This is discussed in several papers. Additionally, arthroscopy may very well be an appropriate method of investigating intra-articular changes in the TMJ caused by trauma. So far, our knowledge about these effects still seems to be insufficient. For several years, the literature has reflected an increasing discussion about alloplastic materials used for interpositioning in the TMJ. A more rational approach in estimating the potential risks of these materials seems to be highly necessary.(ABSTRACT TRUNCATED AT 250 WORDS)