Assessment of Arthroscopic Temporomandibular Joint Disc Repositioning /
Abdel Malak, Abanoub Sliem Ghabious
Assessment of Arthroscopic Temporomandibular Joint Disc Repositioning / تقيي تغيير وٍقع غضروف فٍصو اىفل اىصذغي تاى ظَْار By Abanoub Sliem Ghabious Abdel Malak B.D.S - Future University in Egypt ; Supervisors : Prof. Dr. Ahmed Barakat Professor and Head of Oral& Maxillofacial Surgery Department Faculty of Oral and Dental Medicine Future University in Egypt, Prof. Dr. Sameh Mekhemer Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University, Prof. Dr. Reem Hossameldin Associate Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University - 139 pages : illustrations (chiefly color) ; 30 cm
Supervisors : Prof. Dr. Ahmed Barakat Professor and Head of Oral& Maxillofacial Surgery Department Faculty of Oral and Dental Medicine Future University in Egypt, Prof. Dr. Sameh Mekhemer Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University, Prof. Dr. Reem Hossameldin Associate Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University.
Thesis (M. Sc.)-Future university in Egypt, faculty of oral and dental medicine, 2021.
Bibbliography: (p.127-136)
The aim of the present study was to clinically evaluate the outcomes of advanced arthroscopic disc repositioning (Discopexy) surgery for TMJ internal derangement, Wilkes stage III and early stage IV patients.
Patients with unilateral or bilateral TMJ internal derangement who had unsuccessful conservative treatment for at least three months were randomly selected from the outpatient clinic of oral & maxillofacial surgery department of faculty of dentistry, Future University in Egypt and Cairo University. Exclusion criteria included patients with evidence of major jaw trauma, or deformities as well as systematic diseases affecting the joint.
Arthroscopic disc repositioning was performed after unsuccessful conservative procedures with 6 months follow up period. Before arthroscopic treatment, the patients were examined clinically as well as radiographically using MRI. Based on the clinical and radiological findings, a Wilkes staging was assigned to each joint preoperatively.
Under general anesthesia, arthroscopic discopexy was performed using an arthroscope of 1.9 mm diameter. after a double puncture arthroscopic examination of the superior joint space was performed , then anterior release of the superior belly of the lateral pterygoid muscle from the disc , followed by disc reduction by pressuring on the retrodiscal tissue , then using Meniscus Mender (Disc repositioning kit) the disc is fixed in the reduced position by stainless steel wire passing from the inferior to the superior joint space and the two wire ends attached to a metal button extra-orally to keep the disc reduced .
Post-surgical treatment comprised of a soft diet and full coverage occlusal stabilization splints. Then, the patients did a panoramic x ray before wire removal to check the wire continuity. MRI was done six months postoperatively to check the changes in disc position.
The number of treated patients was 4 patients (total of six joints) all were females; mean age of selected subjects was 20-30 years. The number of unilateral affected joints was two and two bilateral joints. No intra operative complications except one patient had a unilateral transient facial nerve affection which resolved after physiotherapy. There were no signs of infection, bleeding or hematoma.
The main outcomes variable of the current study was to assess the degree of joint pain on VAS and MIO in mm at six months postoperatively. Results showed a statically significant improvement in MIO and a noticeable change in the disc position at the end of the follow up period. Other variables include, VAS, joint noise, joint loading and joint pain which all had insignificant changes.
Temporomandibular joint--Diseases--Diagnosis
Temporomandibular joint--Imaging
Diagnostic imaging
617.522 / A.A.A
Assessment of Arthroscopic Temporomandibular Joint Disc Repositioning / تقيي تغيير وٍقع غضروف فٍصو اىفل اىصذغي تاى ظَْار By Abanoub Sliem Ghabious Abdel Malak B.D.S - Future University in Egypt ; Supervisors : Prof. Dr. Ahmed Barakat Professor and Head of Oral& Maxillofacial Surgery Department Faculty of Oral and Dental Medicine Future University in Egypt, Prof. Dr. Sameh Mekhemer Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University, Prof. Dr. Reem Hossameldin Associate Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University - 139 pages : illustrations (chiefly color) ; 30 cm
Supervisors : Prof. Dr. Ahmed Barakat Professor and Head of Oral& Maxillofacial Surgery Department Faculty of Oral and Dental Medicine Future University in Egypt, Prof. Dr. Sameh Mekhemer Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University, Prof. Dr. Reem Hossameldin Associate Professor of Oral& Maxillofacial Surgery Faculty of Dentistry Cairo University.
Thesis (M. Sc.)-Future university in Egypt, faculty of oral and dental medicine, 2021.
Bibbliography: (p.127-136)
The aim of the present study was to clinically evaluate the outcomes of advanced arthroscopic disc repositioning (Discopexy) surgery for TMJ internal derangement, Wilkes stage III and early stage IV patients.
Patients with unilateral or bilateral TMJ internal derangement who had unsuccessful conservative treatment for at least three months were randomly selected from the outpatient clinic of oral & maxillofacial surgery department of faculty of dentistry, Future University in Egypt and Cairo University. Exclusion criteria included patients with evidence of major jaw trauma, or deformities as well as systematic diseases affecting the joint.
Arthroscopic disc repositioning was performed after unsuccessful conservative procedures with 6 months follow up period. Before arthroscopic treatment, the patients were examined clinically as well as radiographically using MRI. Based on the clinical and radiological findings, a Wilkes staging was assigned to each joint preoperatively.
Under general anesthesia, arthroscopic discopexy was performed using an arthroscope of 1.9 mm diameter. after a double puncture arthroscopic examination of the superior joint space was performed , then anterior release of the superior belly of the lateral pterygoid muscle from the disc , followed by disc reduction by pressuring on the retrodiscal tissue , then using Meniscus Mender (Disc repositioning kit) the disc is fixed in the reduced position by stainless steel wire passing from the inferior to the superior joint space and the two wire ends attached to a metal button extra-orally to keep the disc reduced .
Post-surgical treatment comprised of a soft diet and full coverage occlusal stabilization splints. Then, the patients did a panoramic x ray before wire removal to check the wire continuity. MRI was done six months postoperatively to check the changes in disc position.
The number of treated patients was 4 patients (total of six joints) all were females; mean age of selected subjects was 20-30 years. The number of unilateral affected joints was two and two bilateral joints. No intra operative complications except one patient had a unilateral transient facial nerve affection which resolved after physiotherapy. There were no signs of infection, bleeding or hematoma.
The main outcomes variable of the current study was to assess the degree of joint pain on VAS and MIO in mm at six months postoperatively. Results showed a statically significant improvement in MIO and a noticeable change in the disc position at the end of the follow up period. Other variables include, VAS, joint noise, joint loading and joint pain which all had insignificant changes.
Temporomandibular joint--Diseases--Diagnosis
Temporomandibular joint--Imaging
Diagnostic imaging
617.522 / A.A.A