Bulletin of Stomatology and Maxillofacial Surgery
ISSN 1829-006X
2025; 406–412
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COMPARATIVE EFFICACY OF ARTHROSCOPY VERSUS ARTHROCENTESIS FOR ADVANCED TEMPOROMANDIBULAR JOINT INTERNAL DERANGEMENT: A RANDOMIZED CONTROLLED TRIAL

Received: 2026-04-08 · Published: 2025-07-27

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Original title
COMPARATIVE EFFICACY OF ARTHROSCOPY VERSUS ARTHROCENTESIS FOR ADVANCED TEMPOROMANDIBULAR JOINT INTERNAL DERANGEMENT: A RANDOMIZED CONTROLLED TRIAL
Author
Mokhtar Mahmoud Mokhtar El shershaby
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-07-27
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.6-406

Abstract

Background:Temporomandibular joint internal derangement (TMJID) often leads to orofacial pain and dysfunction, frequently due to abnormal disc-condyle relationships. When conservative treatments fail for advanced TMJID, minimally invasive procedures like arthrocentesis and arthroscopy are considered, but comparative data on their effectiveness remain limited. Materials and methods: This randomized controlled trial enrolled 26 female patients (18-45 years) with advanced TMJID. Patients were randomly assigned to Group A (n=13, arthroscopy) or Group B (n=13, arthrocentesis). Both groups received intra-articular platelet-rich plasma and hyaluronic acid. Baseline and 6-month follow-up assessments included Visual Analog Scale (VAS) for pain, Maximum Voluntary Mouth Opening (MVMO), Maximum Assisted Mouth Opening (MAMO), joint sounds, and MRI findings (disc position, morphology, osteoarthritic changes). Operative duration was recorded. Statistical analysis used SPSS 26.0. Results:Both groups showed significant pain reduction over 6 months, with no significant inter-group difference in VAS scores (p > 0.05). Group A exhibited significantly greater improvements in both MVMO and MAMO compared to Group B at all postoperative time points (p < 0.001). Preoperative clicking (46.2% in both groups) resolved in both groups by 3 months, with no significant inter-group difference at 1 month (p = 0.141). MRI showed improved disc position (transition from DDWOR to DDWR) in both groups by 6 months, with no significant inter-group difference (p = 0.680). Arthroscopy had a significantly longer operative duration (72.08 ± 6.37 min vs. 27.15 ± 2.88 min; p < 0.001). Conclusion: Both arthrocentesis and arthroscopy effectively reduce pain and improve disc position in advanced TMJID. However, arthroscopy demonstrates superior outcomes in improving maximum mouth opening, likely due to its direct ability to address complex intra-articular pathologies.
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