Abstract

Restricted mouth opening and pain are common in anterior disc displacement without reduction of the temporomandibular joint (TMJ). Operative arthroscopy may include an anterior capsulotomy, but the incremental benefit of routinely adding this step to a standardized level II procedure remains uncertain. A multicenter, parallel-group, randomized, participant- and assessor-blinded controlled trial is designed to compare level II temporomandibular joint arthroscopy with lavage and coblation treatment of synovitis performed with or without an anterior capsulotomy. Adults with radiological–confirmed anterior disc displacement without reduction who failed at least three months of conservative management and have an indication for level II arthroscopy are eligible. Eligibility is re-confirmed arthroscopically. Seventy-two participants are allocated 1:1, stratified by center. The primary outcome is maximal interincisal opening at 12 months. Secondary outcomes include pain intensity and the trajectory of maximal interincisal opening over follow-up. This trial will provide pragmatic evidence on whether performing an anterior capsulotomy is effective in operative temporomandibular joint arthroscopy without increasing adverse events.

Keywords

• temporomandibular joint
• arthroscopy
• anterior capsulotomy
• temporomandibular disorders
• randomized controlled trial
• study protocol

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