The role of the holmium laser in increasing the success rate of temporomandibular joint arthroscopic discopexy.

Abstract

The purpose of this study was to compare the effects of anterior releasing of the temporomandibular joint disc during arthroscopic discopexy surgery with a holmium laser versus manual instrumentation. A total of 80 patients (139 joints), divided into two groups. Anterior releasing surgery was performed using manual surgical instruments in 40 patients (70 joints) and with holmium laser assistance in the other 40 patients (69 joints). Statistical analyses, including χ² tests and multivariate analysis, assessed factors impacting surgical success. The results showed that discopexy success was significantly higher with holmium laser use compared to manual instruments (odds ratio 4.41, P = 0.003). In addition, a preoperative diagnosis of anterior disc displacement with reduction (ADDwR) was found to be significantly more likely to result in surgical success compared to anterior disc displacement without reduction (ADDwoR) or idiopathic condylar resorption (odds ratio 5.91, P = 0.001). This study found that the use of holmium laser assistance, as compared to manual surgical instruments, significantly enhanced the success rate of arthroscopic discopexy in the temporomandibular joint. Furthermore, patients classified as ADDwR exhibited a notably higher surgical success rate compared to those classified as ADDwoR or idiopathic condylar resorption.