Cochrane · intervention · CD006385

Arthroscopy for temporomandibular disorders

Cochrane Database of Systematic Reviews · 2011 · Cochrane Library

Oral Health Oral and maxillofacial surgery Temporomandibular disorders and sleep2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 0 · 0%Ungraded 12 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Adults (older than 18 years) with a diagnosis of synovitis, disc displacement with or without reduction, myofascial dysfunction, degenerative diseases or psycho-affective disorders with orofacial pain	Adults with TMD (closed lock, internal derangement, osteoarthritis, disc displacement); 349 patients across 7 RCTs
Intervention	Arthroscopy for TMD	Arthroscopy (various techniques incl. lysis/lavage, arthroscopic anterolateral capsular release)
Comparison	No treatment; Splint therapy; Physiotherapy; Surgery; Pharmacological treatment	Open surgery (arthroplasty, high condylectomy, discectomy); Arthrocentesis; Nonsurgical/medical management
Outcomes	Relief of pain in the TMJ and masticatory muscles; Tenderness during palpation of TMJ and masticatory muscles; Joint sounds or crepitation (Helkimo anamnestic index / dysfunction index); Maximum interincisal opening; Lateral movement; Protrusion; Determination of joint sounds during movement; Proportion of patients improved; Quality of life; Adverse events	Pain after 6 months (n=62); Pain after 12 months (n=81); Mandibular functionality/MFIQ after 12 months (n=40); Clinical evaluations 12 months after surgery, 6 clinical signs (n=240); Maximum interincisal opening after 12 months (n=81)
Study designs	Randomized controlled clinical trials (RCTs)	RCT (n=7)
Timing	Not specified	6 months; 12 months

Search date: 2010-12. Databases: Cochrane Oral Health Group Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; CINAHL; Allied and Complementary Medicine Database (AMED); LILACS

Questions and results

Current version only

Arthroscopy vs Open surgery

Population: Adults (older than 18 years) with a temporomandibular disorder (synovitis, disc displacement with or without reduction, myofascial dysfunction, degenerative disease, or psycho-affective disorder with orofacial pain)

CD006385.PUB2 (current) · 9 questions

Outcome	Effect	Evidence	Status / GRADE
Tenderness on palpation in TMJ (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 0.65 [0.10, 4.04]	2 studies · 40 participants	Ungraded
Maximum protrusion over 5 mm (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 0.12 [0.01, 2.09]	2 studies · 40 participants	Ungraded
Clinical evaluations 12 months after surgery (6 pooled clinical signs) 12 months same question in other reviews	Peto OR 1.0 [0.45, 2.21]	2 studies · 240 participants	Ungraded
Tenderness on palpation in jaw muscles (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 2.00 [0.20, 19.98]	2 studies · 40 participants	Ungraded
Interincisal opening over 35 mm (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 1.31 [0.31, 5.60]	2 studies · 40 participants	Ungraded
Pain (VAS/SSI) after 12 months 12 months same question in other reviews	SMD 0.45 [0.01, 0.89]	3 studies · 81 participants	Ungraded
Click (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 9.35 [0.85, 102.30]	2 studies · 40 participants	Ungraded
Crepitation (clinical evaluation, 12 months) 12 months same question in other reviews	Peto OR 0.45 [0.08, 2.60]	2 studies · 40 participants	Ungraded
Mandibular functionality (MFIQ) after 12 months 12 months same question in other reviews	MD 1.58 [-0.78, 3.94]	2 studies · 40 participants	Ungraded

Arthroscopy vs Arthrocentesis

CD006385.PUB2 (current) · 2 questions

Outcome	Effect	Evidence	Status / GRADE
Maximum interincisal opening (mm) after 12 months 12 months same question in other reviews	MD 5.28 [3.46, 7.10]	2 studies · 81 participants	Ungraded
Pain (VAS) after 12 months 12 months same question in other reviews	MD 0.10 [-1.46, 1.66]	2 studies · 81 participants	Ungraded

Arthroscopy vs Nonsurgical treatment

CD006385.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Pain after 6 months 6 months same question in other reviews	SMD 0.004 [-0.46, 0.55]	2 studies · 62 participants	Ungraded

Arthroscopy vs Open surgery

CD006385 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Protocol (2007): planned comparison of arthroscopy versus open surgery for temporomandibular disorders; no results reported (protocol stage, no studies yet).	0 studies	No studies

Arthroscopy vs Arthrocentesis

CD006385 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Protocol (2007): planned comparison of arthroscopy versus arthrocentesis (other surgery) for temporomandibular disorders; no results reported (protocol stage, no studies yet).	0 studies	No studies

Arthroscopy vs Nonsurgical treatment (no treatment, splint therapy, physiotherapy or pharmacological)

CD006385 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR	Protocol (2007): planned comparison of arthroscopy versus nonsurgical/conservative treatment (no treatment, splint therapy, physiotherapy or pharmacological); no results reported (protocol stage, no studies yet).	0 studies	No studies