الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Temporomandibular disorder generally referred to dysfunction of temporomandibular joint and associated muscles of mastication unrelated to specific dental pain. There are many different types of disorders that may be the source of dysfunction. Temporomandibular joint (TMJ) disc displacement is a disorder characterized by the abnormal position of the articular disc in relation to the mandibular condyle and the mandibular fossa. Disc displacements may be classified as follows: disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR).
The first line of treatment disc displacements was conservative which may involve physical therapy, medications and occlusal splints. In cases not improved with that treatment modalities; it may be essential to induce surgical one either non invasive or invasive open arthrotomy. Invasive procedures always involve some risks such as injuries of the facial nerve (frontal branch), articular structures (disc perforation), and secondary otitis with extravasation of irrigation fluid into the temporal, masseteric and parotid regions. Recently, TMJ ARSCOPY gained wide popularity due to its minimal invasiveness, fewer postoperative clinical complications, and shorter hospital stays, when compared to open surgery. Different arthroscopic procedures and surgical instruments have been reported for management of ID, of particular interest are those specifically dedicated to arthroscopic repositioning and disc release in anterior disc displacement case. Electrocautery is the most common instrument used for arthroscopic disc release. However; recently in the late 20th century radiofrequency ablation instruments play important role instead of traditional one as its harmful effect to surrounding tissues from the high temperature produced.
The current study was conducted to evaluate the efficiency of two cutting instruments for treatment of TMJ ID arthroscopically. The study was designed to be a prospective randomized double blinded trial. Patient’s examination and evaluation were performed by utilizing the RDC/TMD in order to standardize the diagnostic criteria and the method of assessment. Twelve joints were enrolled in our study, randomized equally in to two groups. group I disc release performed by electrocautery probe, however the other group disc release performed by radiofrequency ablation wand. The follow-up period was assigned to be 1, 2, 4 & 8 weeks.
The results of our study revealed significant decrease of pain score in favor of coblation group along the whole follow up period. Moreover, clicking sounds also disappear but non-significantly. Whereas, the mouth opening either assisted or non-assisted showed gradual increase in both groups from the 2 weeks postoperatively up to 2 month but did not reach a significant level. Histological assessment in the current study showed that mean value of apoptotic cells and the percentage of apoptotic cells were decreased significantly in favor of COB group.
So that; we can conclude that coblation more effective in reducing pain than electrocautery.