Arthroscopy versus arthrocentesis in the management of internal derangement of the temporomandibular joint
Bibliographic record
Abstract
Abstract Introduction Temporomandibular joint (TMJ) internal derangement is a relatively common disorder affecting patients of various ages. Different methods have been suggested for treatment, beginning with conservative approaches and ending with surgical modalities. Arthrocentesis and arthroscopic lysis and lavage have been proven to be effective in enhancing the function of the joint and hence improving the quality of life. Objectives To evaluate and compare the effectiveness of arthrocentesis and arthroscopic lysis and lavage in the management of TMJ internal derangement, specifically in relation to pain reduction, range of motion, and postprocedural complications. Patients and methods A retrospective chart review of hospital patients presenting with TMJ internal derangement having been treated with either TMJ arthrocentesis or level 1 arthroscopic lysis and lavage during the January 2018–December 2023 period at a single tertiary center. This study analyzed 76 arthrocentesis patients, including 79 total joints, and 38 arthroscopy patients, including 54 total joints. Results The comparison studies revealed statistical significance in the superior performance of arthroscopic lysis and lavage in the improvement in the muscles of mastication, and TMJ pain, which is measured in visual analog scale ( P < 0.05). In contrast, arthrocentesis demonstrated greater outcomes in improving the range of motion and reducing TMJ sounds ( P < 0.05). No major complications were observed in both procedures. However, arthrocentesis showed a higher incidence of minor postprocedural complications between groups ( P < 0.5). Conclusion Arthrocentesis and arthroscopic lysis and lavage are both effective in the management of TMJ internal derangements. As the results revealed similar effectiveness, arthrocentesis may be better suited for patients with milder conditions, such as Wilkes classifications I, II, or III, and of younger age. Conversely, arthroscopic lysis and lavage may be advised for patients with more severe TMD symptoms, including Wilkes classifications IV or V, and particularly older patients. It may be beneficial to design and conduct a study directly comparing the effectiveness of arthrocentesis and arthroscopy based on the severity of the TMJ condition.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".