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Arthroscopy & Arthrocentesis

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Surgical treatment for TMJ

Dr. Jiang talks about the strength of Arthroscopy 

Arthroscopy & Arthrocentesis

The application of arthroscopy on clinical cases was first reported by Dr. Masatoshi Ohnishi in 1974 and the technology has been improved by various researchers including Holmund, McCain, Sanders and Moses. Nowadays the clinical application of TMJ arthroscopy can be divided into two types: 1) single-puncture arthrocentesis and diagnostic arthroscopy, and 2) multiple puncture and triangulational procedures with special instruments that achieve some goals of open joint surgery. The main purposes of TMJ arthroscopy and arthrocentesis are accurate diagnosis as well as removal of intra-articular inflammatory substances and adhesions to reduce pain, restore the extent of mouth opening and mandibular functions, and diminish joint clicking.
 

Arthroscopy

Arthrocentesis

Comparing Arthroscopy and Traditional Surgery

Indications:
Arthroscopy and arthrocentesis apply for patients with poor response to non-surgical treatment up to 3-6 months or even longer, with persistent TMJ pain and dysfunctional TMJ synovitis, inflammatory arthritis or internal derangement. The clinical signs include limited mouth opening, TMJ clicking combined with painful joint noises. Arthroscopy also plays an important role in definite diagnosis on patients with persistent TMJ pain when physical and imaging examinations do not provide a certain diagnosis.
 

Contradictions:
Clinical or imaging exam has clearly indicated that the stage of TMD is far beyond the treatment capacity of arthroscopy, e.g. TMJ bony ankylosis, severe fibrous ankylosis and condylar resorption.
 

Advantages:
1.Minimally invasive surgery with minimal surgical incision and postoperative facial scar
2.Also possess the advantages of arthrocentesis and diagnostic arthroscopy
3.Capable of combining intra-articular infection of anti-inflammatory drug or hyaluronic acid