Temporomandibular disorder (TMD) is a term used to describe a number of related disorders affecting the temporomandibular joints, masticatory muscles, and associated structures. The prevalence of TMD signs and symptoms is relatively high, but resolves spontaneously in most cases. For those where pain becomes substantial and the limitation of function severe enough to interfere with activities of daily living, treatment is required.
The aim of this systematic review is to assess the effectiveness of surgical treatment (arthrocentesis, arthroscopy and open surgery) compared to nonsurgical treatment for the outcomes of pain and mandibular function in people with TMD. The findings are based on results from five randomised controlled trials and nine controlled cohort studies, comprising 899 participants, mostly women (85%).
Main findings
The differences in pain and maximum mouth opening between the surgical and nonsurgical treatment options were minimal and probably not clinically relevant.
Artrocentesis and open surgery might have some effect compared to nonsurgical treatment in terms of pain.
Arthroscopy seems to have no better effect in terms of pain and possibly less effect on maximum mouth opening than nonsurgical treatment.
The quality of the evidence is low or very low for all comparisons made. We thus lack documentation of sufficient quality to draw firm conclusions about the effectiveness of surgical treatment of TMD compared to nonsurgical treatment.
Keywords: Temporomandibular Joint Disorders; Temporomandibular Joint; Craniomandibular Disorders; Hemostasis, Surgical; TMD.
Copyright ©2013 by The Norwegian Institute of Public Health (NIPH).