| 1338 Systematic Literature Review of Surgical Treatment of Temporomandibular Joint Dysfunction | ||
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M. SAPOSNICK1, C. HAYES1, A. ANTCZAK-BOUCKOMS2, and J. LAU3, 1Harvard University, Boston, MA, USA, 2University of Connecticut, Farmington, USA, 3New England Medical Center, Boston, MA, USA Introduction: Various surgical procedures have been used to treat temporomandibular joint dysfunction (TMD). These techniques include condylotomy, high condylectomy, eminectomy, arthroplasty, diskectomy, disc repositioning, and plication procedures. Despite an extensive literature, there is limited information available to clinicians to show the effectiveness of surgical treatment of severe TMD. Purpose: The purpose of this systematic review is to assess and compare the effectiveness of various surgical procedures (excluding arthroscopy) based on the available evidence in the published literature. Methods: A Medline database search of the English language literature from 1966 through July 2000 utilized a combination of textwords and medical subject headings supplemented with references from primary studies and relevant reviews. In total, 4,594 study abstracts, which included epidemiological, surgical treatment, and diagnostic studies, were identified. Results: A total of 41 surgical papers were retrieved. Of these, 25 papers were included in the systematic review. There were 22 case-series and 3 case-control studies. There was no randomized controlled trial nor prospective comparison study. All subjects had chosen surgical management after extended non-surgical therapy had failed. The most common surgical procedure was diskectomy. The most common outcomes were self-reported pain and maximum incisal opening. The mean percentage of patients who reported no pain after surgery was 67% (±24%). The mean gain in maximum incisal opening post-operatively was 8 mm (±4.17). Conclusion: Due to the lack of a control or comparison group in the studies, it is not possible to definitively establish a cause and effect relationship between the surgery and the outcomes. However, our analysis suggests that patients with severe TMD do experience some improvement in symptoms following surgical treatment. Additional studies are necessary in order to demonstrate the effectiveness of surgical treatment for patients with TMD that fail to respond to conservative treatment.(supported by NIDCR #RO1DE11646) | ||
| Seq #128 - Treatment and Outcomes 3:45 PM-5:00 PM, Thursday, 7 March 2002 San Diego Convention Center Exhibit Hall C | ||
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