Comparative study between classical myotomy, subsynovial myotomy, or posterior ligament electrocoagulation in the arthroscopic management of anterior disc displacement without reduction of the temporomandibular joint.

Anterior disc displacement without reduction of the temporomandibular joint is a prevalent condition associated with pain and functional limitation, and minimally invasive arthroscopic approaches are increasingly favored over open surgery due to lower morbidity. This study compared three arthroscopic interventions: classical myotomy (CM), minimally invasive anterior arthroscopic myotomy (MIAAM), and posterior ligament electrocoagulation (PLE). A total of 86 patients were included: 24 (27.9%) underwent CM, 30 (34.8%) underwent MIAAM, and 32 (37.2%) underwent PLE. Outcomes were assessed using visual analog scale (VAS) pain, maximum mouth opening (MMO), and joint function at baseline and at 1 and 6 months postoperatively. Pain improved significantly over time in all groups (F = 5.02; df = 2; p < 0.05), with no significant differences between techniques. Maximum interincisal opening (MIO) and mandibular protrusion also improved significantly (F = 14.6; df = 2; p < 0.05 and F = 8.949; df = 2; p < 0.05, respectively), again without inter-group differences. MIAAM was associated with faster pain relief at 1 month and slightly better 12-month outcomes, although these differences were not statistically significant. Overall, PLE showed comparatively less favorable results, suggesting MIAAM may represent a balanced option in terms of efficacy and safety.