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Abstract It was designed to evaluate the effect of surgical arthroscopy in management of TMJ internal derangement (anterior disc displacement without reduction and closed lock). Twelve adult female patients were selected from the outpatient clinic of the Oral and Maxillofacial Surgery department, Faculty of Dentistry, Suez Canal University and Faculty of Oral and Dental Medicine, Future University in Egypt.The clinical parameters for success were set at maximum interincisal opening (MIO) of ≥ 40 mm and visual analog scale (VAS) for pain of ≤ 1 at the end of the study. These parameters were recorded preoperatively, 1 week, 1, 3, 6, 9 and 12 months postoperatively. All patients underwent surgical arthroscopy under general anesthesia; the procedure entailed multiple arthroscopic entry points and lysis of intraarticular adhesions using arthroscopic hand instruments and motorized shavers. MIO was improved in all patients from 24 ± 4 mm preoperatively to 43 ± 3.2 mm postoperatively, which was statistically significant using ANOVA (P<0.0001). Moreover, VAS for pain showed statistically significant decrease with a mean value of 0.2 ± 0.6 at the end of the study. Summary & Conclusions 88 Conclusions: from the results of the current study it could be concluded that: Proper diagnosis and classification of ID with the aid of MRI is crucial and influential on the treatment planning and consequently the clinical outcome. Arthroscopic lysis and lavage of intraarticular adhesions is reliable, safe and effective treatment for TMJ closed lock in patients who fail to respond to conservative non surgical treatment. Physiotherapy and early function following TMJ surgery plays an important role in the postoperative course. Repositioning or reduction of displaced discs is not a prerequisite for clinical success in symptomatic patients. Recommendations: Further study of a larger sample size with the current standardized protocol is necessary. A longer follow up period to detect the long term effect of such a method. Placement of double pellets and lubricating gel in the external auditory canals prior to arthroscopic TMJ surgery. Summary & Conclusions 011 TMJ arthroscopy for ID patients is a crucial treatment modality that should be performed prior to attempting more invasive treatments. |