Authors of section

Authors

Nicolas Homsi, Paulo Rodrigues, Gregorio Sánchez Aniceto, Beat Hammer, Scott Bartlett

Executive Editors

Edward Ellis III, Eduardo Rodriguez

General Editor

Daniel Buchbinder

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Arthrocentesis, discoplasty and discectomy

1. Introduction

Arthrocentesis, discoplasty and discectomy is outside the scope of this surgery reference, however it can be summarized as follows:

2. Arthrocentesis

Arthrocentesis with without the use of an arthroscope is a minimally invasive procedure that brings comfort and increases the mandibular range of motion. It is indicated for patients in whom non-invasive forms of treatment (ie physical therapy, dental splints, etc). gave unsatisfactory results. It involves the irrigation of the superior joint space with saline solution and if needed, the instillation of steroids to diminish intra-articular inflammation.

Arthrocentesis is indicated for:

  • Hypomobility caused by an internal derangement of the TMJ
  • Reducing disk displacement associated with pain, unresponsive to nonsurgical treatment
  • To relief acute pain
  • Non-reducing disk displacement
arthrocentesis discoplasty and discectomy

3. Discoplasty

Discoplasty can involve reshaping, repairing, and/or repositioning of the articular disk. It is performed through an arthrotomy or arthroscopically.

Discoplasty (reshaping, recontouring or repositioning of the disk) is indicated for:

  • Hypomobility caused by an internal derangement of the TMJ
  • Anterior disk displacement with reduction and pain unresponsive to arthrocentesis
  • Anterior disk replacement without reduction unresponsive to arthrocentesis

arthrocentesis discoplasty and discectomy

4. Discectomy

Discectomy is defined as the removal of a disk that is not repositionable or repairable.

This procedure may be followed by the insertion of interpositional material (eg. dermis, cartilage), which will function as a neo-disc.

Discectomy (removal of the disk with or without replacement) is indicated for:

  • Hypomobility caused by an internal derangement of the TMJ
  • Disk not repositionable
  • Non repairable perforation
  • Severe degeneration of the disk
arthrocentesis discoplasty and discectomy