Risk factors for the poor clinical outcome of visually guided temporomandibular joint irrigation in patients with chronic closed lock

Abstract

Objective

This study aimed to explore the risk factors of poor clinical outcome of visually guided irrigation (VGIR) in patients with chronic closed lock (CCL) of the temporomandibular joint (TMJ).

Materials and methods

Sixty-one patients with unilateral CCL who underwent a VGIR were enrolled in this study. At the 3-month follow-up after VGIR, the 61 patients were divided into either the good outcome (g-) group (n = 37) or poor outcome (p-) group (n = 24), according to the clinical success criteria. Age, gender, duration of symptoms, preoperative painless range of mandibular motion (P-ROM), preoperative TMJ pain, muscle symptoms, MRI findings (the severity of bony change, disc deformity and joint effusion), and arthroscopic findings (the severity of osteoarthritic change, synovial lesion and fibrous adhesion) were selected as the candidates of prognostic factors for VGIR. Each factor was compared between the two groups. Moreover, multiple logistic regression analysis was performed.

Result

The preoperative P-ROM of the p-group was significantly lower than that of the g-group. The severity of osteoarthritic change in the p-group was significantly greater than that of the g-group. Regarding the MRI findings, there were no significant differences between the two groups. The multivariate adjusted odds ratio showed that only a decreased preoperative P-ROM was significantly predictive for a poor clinical outcome of VGIR.

Conclusion

A pronounced decrease of preoperative P-ROM would be a significant risk factor for a poor clinical outcome of TMJ irrigation in patients with CCL.