الفهرس 
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Abstract
The purpose of this study was to evaluate the clinical outcome and the changes in disc position, mobility, and morphology in patients with temporomandibular joint closed lock in response to arthroscopic lysis and lavage versus arthrocentesis using (MRI).
Subjects were chosen to participate in this study suffered from closed lock, based on clinical and MRI findings. Twelve out of 23 patients (52.17%) did not respond to the used conservative therapy. Their ages ranged from 22-34 years, with an average of 29.4 years. They were all females. They were assigned in into 1 of 2 equal groups:
Group I:
-Arthroscopic lysis and lavage was performed with intra-articular injection of 1ml of Depomedrole (40mg/1ml) at the end of the procedure.
Group II:
-Arthrocentesis was performed with intra-articular injection of 1ml of Depomedrole (40mg/1ml) at the end of the procedure.
The evaluated parameters include assessment of articular pain (0 – 10 NRS), MMO and mandibular dysfunction as expressed by Helkimo index scores. The clinical outcome measure parameters were assessed preoperatively, then 1 week and 3 months postoperatively. The treatment outcome was judged according to our success criteria. The MRI parameters including changes in disk position, mobility, and morphology and clinical outcomes were statistically analyzed.
Summary and Conclusion
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By the end of the present study, arthroscopic group showed significant reduction of pain and increase in mouth opening and insignificant decrease of Helkimo index score when compared with those of the arthrocentesis group. According to our success criteria, the arthroscopic group showed 100% success while 4 out of 6 cases (66.7%) were successful in the arthrocentesis group.
MRI assessment revealed considerable improvement in the evaluated parameter by time in both groups. Postoperatively, there was no statistically significant difference between the two groups with regard to disc position, disc mobility and disc configuration. However, arthroscopy group showed statistically significant higher prevalence of condylar translation than arthrocentesis group
Conclusions
The efficacy of TMJ arthrocentesis and arthroscopy for treatment of closed lock is emphasized once again to reduce symptoms of pain and limited mouth opening. However, the clinical efficacy of arthrocentesis is somewhat inferior to that of arthroscopic surgery. Nevertheless, its simplicity makes it the treatment of choice when conservative therapy failed.