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Visually guided temporomandibular joint irrigation in patients with chronic closed lock: clinical outcome and its relationship to intra-articular morphologic changes.

OBJECTIVE
The aim of this study was to evaluate the clinical outcome after visually guided irrigation (VGIR) of the temporomandibular joint (TMJ) and its relationship with postoperative arthroscopic changes.


STUDY DESIGN
Of the original 69 patients, thirty patients (30 TMJs) underwent VGIR of the TMJ a second time. After the first VGIR, the clinical outcome was assessed, and 18 patients were assigned to the good outcome group. The remaining 12 patients were assigned to the poor outcome group. The arthroscopic findings related to the articular surface, synovial lining, and fibrous adhesion scores were recorded. Then, the arthroscopic findings in the first and second VGIR were compared.


RESULTS
The intra-articular tissue status between the first and second VGIR was unchanged in approximately 40% of all joints. No significant differences with respect to an improvement in tissue status were found when the good outcome and poor outcome groups were compared.


CONCLUSIONS
In patients with chronic closed lock of the TMJ, a clinical improvement after VGIR does not seem to be accompanied by improved intra-articular tissue status.