Comparison of the TMJ arthroscopy discopexy techniques: A systematic review and meta-analysis

Autores organización

• David Augusto Diaz Baez

  Autor

Autores

• López J.P.
• Orjuela M.P.
• González L.V.

Unidades de investigación

• Unidad de Investigación Básica Oral UIBO

  

  Investigador

  Gloria Ines Lafaurie Villamil

Resumen

This article aims to analyze which of the main arthroscopic discopexy techniques has the best results and if there are differences between the techniques for both pain and maxillary intercuspid opening. A systematic review and meta-analysis was performed according to the PRISMA statement. An electronic search was performed with no publication date restriction in PubMed, Ovid and Embase. The PICO criteria: (P) Patients: With temporomandibular internal disorders with discopexy indication. (I) Intervention: Temporomandibular joint arthroscopic discopexy. (C) Comparison: Arthroscopic discopexy among different techniques classified as non-rigid, semi-rigid and rigid. (O) Outcomes: Impact in clinical conditions such as pain and maximum mouth opening. The inclusion criteria were Patients with temporomandibular internal disorders with discopexy indication performed with different techniques classified as non-rigid, semi-rigid and rigid. The outcomes evaluated were pain and maximum mouth opening. Case series, cohort studies, quasi-experimental studies, and randomized clinical trials with at least 3 months of follow-up were included. The exclusion criteria considered were patients with related concomitant surgeries, patients with associated neoplastic disease or connective tissue disease. A total of 1515 joints where 1400 discopexies were performed including 849 females and 204 males. The most common diagnostic was Wilkes stage III in 257 joints. For pain and oral opening, the semi-rigid technique shows the best results median (MD) 4.84 (CI 2.52–7.16; p = 0.001, I2:100%), MD -2.78 (CI -4.34, -1.21; p = 0.001, I2:99%), respectively. The rigid technique has the greatest probability for complications MD 0.14 CI 95% (0.00, -0.28). Although the semi-rigid technique showed better results, there is no statistically significant difference. However, due to the heterogeneity of the studies, the results should be interpreted with caution. © 2024 European Association for Cranio-Maxillo-Facial Surgery

Keywords

• Complications; Operative arthroscopy; Temporomandibular joint; TMJ discopexy;Arthroscopy; Humans; Temporomandibular Joint Disc; Temporomandibular Joint Disorders; adolescent; adult; anchor dislodgement; arthralgia; arthroscopy; clinical evaluation; clinical outcome; comparative study; connective tissue disease; data extraction; data synthesis; disease association; facial nerve paralysis; female; follow up; human; intermethod comparison; jaw disease; male; malocclusion; medical device complication; meta analysis; mouth; neoplasm; non rigid technique; postoperative complication; postoperative period; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; quasi experimental study; randomized controlled trial (topic); Review; rigid technique; semi rigid technique; surgical technique; symptom; systematic review; temporomandibular joint; temporomandibular joint arthroscopic discopexy; treatment indication; young adult; procedures; temporomandibular joint disc; temporomandibular