Arthroscopy of the temporomandibular joint (TMJ) is a technique that, on one hand, brings us close to the knowledge of the physiopathology of this joint and, on the other, has revolutionized the treatment of this joint for essentially what is known as the TMJ pain-dysfunction syndrome (TMDS). In the year 1986, articles began to be published confirming the improvement in the clinical symptomatology of patients with TMJ dysfunction who were submitted to diagnostic arthroscopy for the simple fact of washing with abundant saline and passing over the joint surfaces with the arthroscope. This adaptation of a device from conventional arthroscopic surgery has facilitated the emergence of a number of techniques which have revolutionized the treatment of TMJ pathology. In general, the development of arthroscopic techniques for the TMJ have been based on the experience of conventional arthroscopy of traumatologists and orthopedists in relation to other joints, generally larger in size.
This treatment would be directed to patients in which conservative treatment fails and in which open surgery could be considered an excessive treatment. In addition, it is true that there are steadily more indications for arthroscopy in more serious or more advanced cases of TMJ pathology.
We will examine different techniques from diagnostic arthroscopy to suturing techniques. The techniques used can be classified as:
- Lysis, lavage, and manipulation. These are the most frequently used. The term “lysis”, used by Sanders, refers to “to sweep surface adhesions in the superior joint space where the goal is to increase the disc mobility”.
- Disk-repositioning techniques. These refer to the techniques called suturing and resuturing, although electrocoagulation of the retrodiscal tissues can also be considered,
- Injection of intra-articular substances. These include, for example, sodium hyaluronate, corticoids, viscoelastic substances, plasma rich in growth factors.