West China Journal of Stomatology

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Arthroscopic Diagnosis for Intraarticular Adhesion of Temporomandibular Joint

ZHANG Shan-yong, YANG Chi, WANG Xu-dong   

  1. Dept. ofOral andMaxillofacialSurgery, TheNinthPeople′sHospital, School ofStomatology, ShanghaiSecondMed- ical University, Shanghai200011, China
  • Received:2005-08-25 Revised:2005-08-25 Online:2005-08-20 Published:2005-08-20

Abstract:

Objective To demonstrate the incidence ratio of intraarticular adhesion (ID), arthroscopic findings of adhesions were evaluated by means of its shape, location and degree. To evaluate the correlation between intraarticular adhesion and the fol- lowing index, including patients′age, locking duration and interincisal opening preoperatively.Methods 280 consecutive arthro- scopically examined joints in 251 patients were evaluated. Two surgeons discussed and recorded the shape, location and degree of adhesion nine parts of the temporomandibular joint (TMJ) upper compartment on the chart. The adhesion ratio in different regions and the relation between different grades and ID stages of adhesions were calculated. The patients with ID stageⅢ,Ⅳ, Vwere divided into two groups, one with adhesion, and the otherwithout. Interincisal opening, locking duration and age were compared between two groups usingt-test.Results Of all 280 joints, 157 joints had adhesions, which accounted for 56·07%.The adhe- sion of grade 1 accounted for 44·59%, grade 2 for 32.48%, grade 3 for 7·64%, and grade 4 for 15·29%. The proportions of different grades in different stage were as follows. The joints with adhesion in StageⅡaccounted for 10·81%, StageⅢfor 48·76%, StageⅣfor 75·61%, and StageⅤfor 77·78%. There were 223 patients who suffered from IDⅢ~Ⅴ. All of 223 patients were divided intothe groupwith adhesion (136 patients) and the othergroupwithout adhesion(87 patients). The patients′ age, interincisal opening and locking duration between two groupswere statistically significant difference(P<0·001).Conclusion  Arthroscopic findings confirmed that the incidence ratio of adhesionwas high, mainly occurred in the older patientswith longer locking duration and less interincisal opening. With the higher stage of ID, the adhesion′grades rise.

Key words: temporomandibular joint, intraarticular adhesions, arthroscopy