ABSTRACT
INTRODUCTION: Internal derangements (ID) of the temporomandibular joint (TMJ) have a multifactorial etiology and are most often treated conservatively by splints, physical therapy and medications. Only in 2-5% of cases are the treatment surgical, either by arthroscopy or arthrotomy.OBJECTIVE: To evaluate improvement of mouth opening, pain relief during function, position of the articular disk and complications following Arthroscopic Lyse and Lavage (ALL).METHODS: A prospective study of 78 patients (138 TMJs) with TMJ ID, 5 males and 73 females, mean age 29.7 years, treated between January 2010 and April 2013, who were refractory to conservative treatment, had limited mouth opening and pain localized to the TMJ during function, and who were submitted to TMJ ALL and followed for a period of 12 months, with periodic reviews.RESULTS: ALL was effective in 93.6% of cases, with 85.3% experiencing improvement in mouth opening and 91.2% in pain reduction during function, 63% improvement in disk position and a rate of complications of 6.2%.CONCLUSION: In this study the ALL exhibited a high rate of success with low morbidity in internal derangements of the TMJ.
INTRODUÇÃO: Os desarranjos internos (DI) da articulação temporomandibular (ATM), possuem etiologia multifatorial, sendo tratados na maioria das vezes de forma conservadora através splints, fisioterapia e medicamentos. Apenas 2% a 5% dos casos tem indicação cirúrgica, seja através de artroscopia ou artrotomia.OBJETIVO: Avaliar melhora da abertura bucal, melhora da dor, posicionamento do disco articular e complicações pós Lise e Lavagem Artroscópica (ALL).MÉTODO: Estudo prospectivo com uma serie de 78 pacientes (138 ATMs) com DI da ATM, sendo 5 homens e 73 mulheres, com média etária de 29,7 anos, atendidos entre janeiro de 2010 e abril de 2013, refratários ao tratamento conservador, apresentando limitação de abertura bucal e dor localizada em ATM em função, sendo submetidos à ALL da ATM e acompanhados por um período de 12 meses, com avaliações periódicas.RESULTADOS: A ALL foi eficiente em 93,6 % dos casos estudados, com 85,3% melhora na abertura bucal e 91,2% na redução da dor em função, 63% de melhora na posição discal em IRM de controle e índice 6,2% de complicações.CONCLUSÃO: No presente estudo a ALL mostrou-se um tratamento com um alto índice de sucesso, com baixa morbidade, nos desarranjos internos da ATM.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Arthroscopy/methods , Temporomandibular Joint Disorders/surgery , Arthroscopy/instrumentation , Prospective Studies , Range of Motion, Articular , Treatment OutcomeABSTRACT
Los desórdenes temporomandibulares son la causa más frecuente de dolor no dental en la región orofacial. Se caracterizan por dolor y disfunción del sistema masticatorio. Objetivo: Describir las características clínicas de los pacientes con desórdenes temporomandibulares del Hospital de San José. Materiales y métodos: Serie de casos. Se incluyeron los pacientes con diagnóstico de desórdenes temporomandibulares durante junio del 2010 a junio del 2013. Resultado: Se identificaron 284 registros, con un promedio de edad de 41,5 años (DE 17,3). El 81,7% eran mujeres. El síntoma reportado con mayor frecuencia por el paciente fue dolor, con el 86,6%. La media de apertura oral fue 3,8 cm (DE 0,7). La resonancia magnética constituyó el examen más solicitado, con el 16,5%. El tratamiento médico más indicado fue la combinación de placa miorrelajante, dieta blanda y terapia térmica, con el 57%. El 18,6% de los pacientes con disfunción temporomandibular requirieron manejo quirúrgico. Conclusión: Al describir las características de los pacientes con desórdenes temporo-mandibulares en el Servicio de Cirugía Maxilofacial del Hospital de San José, en el periodo de junio del 2010 a junio del 2013, se puede concluir que el sexo que más presenta esta patología es el femenino, en mayores de 40 años, posiblemente por alteraciones oclusales debidas a mala adaptación protésica o ausencia de piezas dentales, estrés, presencia de hábitos parafuncionales asociados a posibles cambios artrósicos por la edad...
Temporomandibular joint disorders are the most frequent cause of non-dental orofacial pain. They are characterized by pain and mastication system dysfunction. Objective: To describe the clinical characteristics of patients with temporomandibular joint disorders at Hospital de San José. Materials and methods: Case series. Patients diagnosed with temporomandibular joint disorders between June 2010 and June 2013 were included. Results: Overall, 284 records were identified of patients with a mean age 41.5 years (SD 17.3). Of those, 81.7% were women. The most frequent symptom reported by the patients was pain (86.6%). Mean oral opening was 3.8 cm (SD 0.7). Nuclear magnetic resonance was the most requested study (16.5%). The medical treatment most frequently indicated was a combination of splint, soft diet and thermal therapy (57 %). Of the patients with temporomandibular dysfunction, 18.6% required surgical management. Conclusion: Based on the description of the characteristics of patientes with temporomandibular joint disorders coming to the Maxillofacial Surgery Service at Hospital de San José, between June 210 and June 2013, it may be concluded that this disorder is more frequent in the female gender and in people over 40. This may be explained perhaps by the occlusion abnormalities due to poor prosthetic fitting or absence of teeth, stress, or habitus associated with potential age-related arthrosis changes...