Purpose: This study conducted a long-term follow-up of signs and symptoms of temporomandibular disorders (TMDs) in adults who had developed TMDs under the age of 15 years.
Method: Questionnaires were mailed to 201 people (46 men and 155 women) who met the following criteria: (1) 20 years old or above; (2) with a history of visiting us because of their TMD when they were 15 years old or below; and (3) received nonsurgical treatment at that time.
Results:
1. Investigation on questionnaire candidates (201 subjects)
The male to female ratio was 1: 3.4. The youngest patient was 8 years old, and the number of patients increased as age advanced. Patients with Type III were predominant, accounting for 86.1%. Obvious bone changes in the TMJ (type IV) were observed in 3% of the patients.
2. Questionnaire analysis (84 subjects)
Eighty-four people (41.8%) answered the questionnaire, and were analyzed for a comparison of the symptoms between the first visit and the questionnaire survey. The duration ranged from 5.5 to 16.6 years (median: 9.8 years). There were significant decreases between the first visit and the questionnaire survey in a majority of subjects with TMJ sounds, and pain around the TMD and masticatory muscles (70.0% to 51.4%, 82.9% to 22.9%, respectively) (p<0.01). The means of interincisal distance significantly increased from 40.0 to 51.2mm in males, and from 36.5 to 46.3mm in females, (p<0.001, respectively), and the means in the questionnaire survey were compatible with those reported in non-TMD Japanese. The symptoms had improved or had been stable in 79.8%. Sixty-two subjects (73.8%) reported that they felt no need for their present symptoms. In unilateral cases, 12.9% subjects reported that some pain had developed in the previously asymptomatic side.
Conclusion: The signs and symptoms in people who developed TMD at an early age became mild in general in adulthood.

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We clinically applied a high-frequency electric knife (ArthroCare Multi-electrode system 2000^TM), which has been used in the fields of neurosurgery, orthopedic surgery, and otorhinolaryngology, to arthroscopic surgery of the temporomandibular joint. More efficient and less invasive arthroscopic surgery could be performed with this system than with methods used previously.
This system was used in 12 joints of 10 patients (one male and 9 females with a mean age of 47.3 years; Group A) with temporomandibular disorders (TMD), and the results were compared with those in 37 joints of 32 patients (2 males and 30 females with a mean age of 34.9 years) who underwent surgery using a Holmium YAG laser and power shaver system (Group HP) with TMD. The range of mouth opening improved from 26mm before surgery to 41mm after surgery in Group A and from 30mm to 42mm in Group HP; the VAS score of pain during jaw movements decreased from 71 to 0.5 in Group A and from 68 to 0.3 in Group HP; no difference was observed between the two groups. In addition, no difference was observed in quantitative evaluation by a questionnaire survey. In Group A, however, there was no obstruction of the surgical field by bleeding during detachment or separation of intraarticular tissues, and the operation time was shortened. These factors improved the efficiency of surgery of the temporomandibular joint.
This system, which improves the safety and efficiency of surgery, is expected to be applicable also to arthroscopic surgery of the temporomandibular joint.

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The objective of this study was to characterize the clinical and temporomandibular joint MRI initial findings of patients with anterior disc displacement without reduction (ADDw/oR) who did not respond to conservative treatments. Following the conservative treatments, 52 ADDw/oR patients were divided into two groups, responders and non-responders, according to their symptoms and treatment satisfaction. Comparisons of initial demographic data, self-reported symptoms, clinical signs, MRI findings and other factors were performed to identify the risk factors. The results indicated that non-responders had statistically significant less initial mouth opening and higher incidence of stuck disc and no disc shape changes during mouth opening. Multiple logistic regression analysis also revealed that the combination of these three factors gave the highest odd ratios. We concluded that initial mouth opening, stuck disc and unchanged disc shape during mouth opening can be used to predict non-responsive outcomes to conservative treatment for ADDw/oR.

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