Ultra-thin Rigid diagnostic and therapeutic arthroscopy during arthrocentesis: Development and preliminary clinical findings / 대한악안면성형재건외과학회지

Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

Clinical Aspect of Arthrocentesis

The temporomandibular joint arthrocentesis is indicated the `closed lock' due to anterior disc displacement without reduction. It can be easily carried out under local anesthesia with little complications. We performed arthrocentesis to the 24 patients, 9 patients who suffered from acute or chronic closed lock with anterior disc displacement, 2 patients from temporomandibular joint dysfunction related to systemic disease and 13 patients from joint dysfunction with pain. We present the common clinical aspect of arthrocentesis that operator can be easily faced with and possible modifications of this method.

Closed Lock of the Jaw on Induction of Anesthesia / 대한마취과학회지

The temporomandibular joint (TMJ) is unique among joints in the human body, since it can be dislocated without external force. Manipulation of the upper airway other than laryngoscopy is a risk factor in patients who have a history of habitual dislocation of the TMJ. The case report illustrates that severe limitation of the jaw opening ("closed lock") requiring manipulation for restoration may occur during induction of general anesthesia.

The effects of changes of mandibular position on temporomandibular joint in adult rabbits whose retrodiscal tissues were incised / 대한치과교정학회지

The purpose of this experiment was to study the effects of changes of mandibular position on temporomandibular joint in internal derangement patients. Twenty-four female New Zealand White Rabbits, weighing over 3.5kg, were utilized in this study. Bilateral temporomandibular joint surgery was performed in twenty one of the rabbits to displace disc anteriorly through incising the retrodiscal tissue 1-2mm posterior to the disc, thus inducing internal derangement. They were divided into three groups: nine were left untreated after surgery, six were fitted with functional protrusive appliances 4 weeks after surgery, and six wore collar appliances to apply 4 ounces of mandibular retractive force per side 4 weeks after surgery. The remaining three served as the control group. Histologic examinations were performed after sacrificing them by threes at 4-week intervals. The results were as follows: 1. Histologic findings similar to internal derangement were observed in the rabbits whose retrodiscal tissues had been incised. 2. In the rabbits untreated after surgery, articular surface on condylar process and articular eminence showed severe erosion and deformation, and displaced disc manifested changes in both shape and internal architecture. 3. Functional protrusion after surgery resulted in progressive remodeling on posterosuperior portion of condyle and glenoid fossa, while it also brought about erosion on articular eminence and anterior portion of condyle. 4. Mandibular retraction after surgery resulted in compression of retrodiscal tissue and regressive remodeling of posterior portion of condyle.