The Outcome of Temporomandibular Joint Disc Repositioning with Retrodiscal Contracture

Statement of the Problem: One of the common surgical procedure for management of mechanical interferences in TMJ is disc repositioning procedure. Disc repositioning for TMJ internal derangement is established procedure with variable success and means of fixation. The purpose of this study is to assess the outcome of using temporomandibular joint (TMJ) arthroscopy disc repositioning with retrodiscal contracture as a minimally invasive surgical treatment for TMJ internal derangement (ID).

Materials and Methods: 25 patients, were treated in the period from 2015-‌ 2017. All patients were evaluated for changes in preoperative versus postoperative clinical assessment through visual analog scale score (VAS), maximum interincisal opening distance, Joint loading Sign, joint noise and pain, muscle pain, diet and medication intake.
Methods of Data Analysis: All patients were followed up for 1 year after treatment. Statistical analyses included the Student t test and Chi square test to determine if there were significant differences in preoperative and postoperative assessments.

Results: 25 patients (32 TMJ), the mean age was 39 years; 21 were female and 4 male. 13 classified as Wilkes II, 19 as Wilkes III. The success rate was 72% based on improvement of joint pain. The study showed statistically significant improvement in all outcome variables except muscle pain.

Conclusion: Clinical outcome data presented show that TMJ arthroscopy disc repositioning with retrodiscal contracture is an effective, predictable surgical treatment. The present study further specifies Wilkes II, early III TMD patients as the most successful category of patients for such procedure.