{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:27:36Z","timestamp":1789669656185,"version":"4.0.1"},"reference-count":49,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Society of Rheumatology"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Over recent years, temporomandibular joint (TMJ) minimally invasive procedures, such as arthrocentesis and arthroscopy, have been appointed as an initial TMJ intra-articular treatment. Both procedures present safe and effective clinical results in managing temporomandibular disorders (TMD) by reducing pain and improving mouth opening. The use of these techniques in adults is validated in the literature. However, data on the safety and effectiveness of minimally invasive TMJ interventions in pediatric patients are scarce. This study aims to investigate the effectiveness of TMJ arthrocentesis and arthroscopy in the pediatric population. A prospective study was conducted at Instituto Portugu\u00eas da Face (IPF) in Lisbon, Portugal, including patients treated for TMD from 1 June 2019 to 30 June 2023. In the present study, 26 patients (17 female and 9 male) were included, representing a total of 48 joints operated. A statistically significant reduction was observed in the primary outcome, TMJ pain, from 3.93 \u00b1 2.80 preoperatively (mean \u00b1 SD) to 0.50 \u00b1 1.53 (mean \u00b1 SD) postoperatively (p &lt; 0.05). An improvement in the secondary outcome, maximum mouth opening, from 36.92 \u00b1 8.79 preoperatively to 42.96 \u00b1 5.07 postoperatively, was observed (p &lt; 0.05). The overall success rate was 84.62%. This prospective study showed that TMJ arthrocentesis and arthroscopy appear to benefit pediatric patients with TMD, significantly lowering pain and improving MMO without relevant postoperative complications.<\/jats:p>","DOI":"10.3390\/jcm13030672","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T09:57:42Z","timestamp":1706090262000},"page":"672","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Temporomandibular Joint Minimally Invasive Procedures in the Pediatric Population: A Prospective Study"],"prefix":"10.3390","volume":"13","author":[{"given":"David Faustino","family":"\u00c2ngelo","sequence":"first","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"},{"name":"Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, 2430-028 Marinha Grande, Portugal"},{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udia Sacramento","family":"Lopes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Sanz","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Faria-Teixeira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Lisboa University, 1649-028 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rute","family":"Marques","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1293-2107","authenticated-orcid":false,"given":"Francesco","family":"Maffia","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"},{"name":"Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples \u201cFederico II\u201d, Via Sergio Pansini 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5750-2875","authenticated-orcid":false,"given":"Henrique Jos\u00e9","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas da Face, 1500-493 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.ijom.2021.01.011","article-title":"Timing of arthrocentesis in the management of temporomandibular disorders: An integrative review and meta-analysis","volume":"50","author":"Li","year":"2021","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1016\/j.ijom.2020.07.020","article-title":"Surgical complications related to temporomandibular joint arthroscopy: A prospective analysis of 39 single-portal versus 43 double-portal procedures","volume":"50","author":"Sanz","year":"2021","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jcms.2023.09.010","article-title":"Effectiveness of double-puncture temporomandibular joint arthrocentesis with viscosupplementation in different categories of severity-a prospective study","volume":"51","author":"Sanz","year":"2023","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.joms.2005.05.063","article-title":"Minimally Invasive TMJ Surgery: From Arthrocentesis to Advanced Laser Arthroscopy","volume":"63","author":"Tarro","year":"2005","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_5","first-page":"264","article-title":"Complications and post-operative sequelae of temporomandibular joint arthrocentesis","volume":"36","author":"Vaira","year":"2018","journal-title":"Cranio J. Craniomandib. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"158","DOI":"10.4103\/ams.ams_160_17","article-title":"Arthrocentesis of Temporomandibular Joint- Bridging the Gap Between Non-Surgical and Surgical Treatment","volume":"9","author":"Soni","year":"2019","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.jcms.2022.06.011","article-title":"Intraoperative complications in temporomandibular joint arthroscopy: A retrospective observational analysis of 899 arthroscopies","volume":"50","year":"2022","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/j.bjoms.2021.05.007","article-title":"Does arthroscopy cause more complications than arthrocentesis in patients with internal temporomandibular joint disorders? Systematic review and meta-analysis","volume":"59","author":"Nogueira","year":"2021","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.cden.2011.03.001","article-title":"Technological Advances in Minimally Invasive TMJ Surgery","volume":"55","author":"Wolf","year":"2011","journal-title":"Dent. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.coms.2014.09.006","article-title":"The Current Role and the Future of Minimally Invasive Temporomandibular Joint Surgery","volume":"27","year":"2015","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jcms.2019.10.004","article-title":"The hierarchy of different treatments for arthrogenous temporomandibular disorders: A network meta-analysis of randomized clinical trials","volume":"48","author":"Wolford","year":"2020","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.ijom.2022.08.018","article-title":"Arthrocentesis versus non-surgical intervention as initial treatment for temporomandibular joint arthralgia: A randomized controlled trial with long-term follow-up","volume":"52","author":"Tang","year":"2023","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/S0278-2391(89)80035-7","article-title":"TMJ arthroscopic surgery: An analysis of 237 patients","volume":"47","author":"Moses","year":"1989","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_14","first-page":"Cd006385","article-title":"Arthroscopy for temporomandibular disorders","volume":"5","author":"Rigon","year":"2011","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/S0278-2391(96)90526-1","article-title":"Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders","volume":"54","author":"Fridrich","year":"1996","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"6167","DOI":"10.1007\/s00784-023-05233-6","article-title":"Bilateral arthroscopy of the temporomandibular joint: Clinical outcomes and the role of a second intervention-a prospective study","volume":"27","author":"Sanz","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.coms.2017.08.001","article-title":"Nonsurgical Management of Pediatric Temporomandibular Joint Dysfunction","volume":"30","author":"Scrivani","year":"2018","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.arcped.2023.03.005","article-title":"Temporomandibular disorders in children and adolescents: A review","volume":"30","author":"Sixou","year":"2023","journal-title":"Arch. De P\u00e9diatrie"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Derwich, M., Gottesman, L., Urbanska, K., and Pawlowska, E. (2022). Craniovertebral and Craniomandibular Changes in Patients with Temporomandibular Joint Disorders after Physiotherapy Combined with Occlusal Splint Therapy: A Prospective Case Control Study. Medicina, 58.","DOI":"10.3390\/medicina58050684"},{"key":"ref_20","first-page":"h7","article-title":"Pharmacotherapy in Temporomandibular Disorders: A Review","volume":"83","author":"Ouanounou","year":"2017","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.ijom.2012.11.004","article-title":"A new surgical classification for temporomandibular joint disorders","volume":"42","author":"Dimitroulis","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/joor.12663","article-title":"International consensus on the assessment of bruxism: Report of a work in progress","volume":"45","author":"Lobbezoo","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0304-3959(01)00314-1","article-title":"The Faces Pain Scale-Revised: Toward a common metric in pediatric pain measurement","volume":"93","author":"Hicks","year":"2001","journal-title":"Pain"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.archoralbio.2017.06.029","article-title":"Does pain in the masseter and anterior temporal muscles influence maximal bite force?","volume":"83","author":"Goiato","year":"2017","journal-title":"Arch. Oral Biol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1053\/joms.2001.24288","article-title":"Discectomy as an effective treatment for painful temporomandibular joint internal derangement: A 5-year clinical and radiographic follow-up","volume":"59","author":"Eriksson","year":"2001","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"\u00c2ngelo, D.F., Sanz, D., Maffia, F., and Cardoso, H.J. (2023). Outcomes of IncobotulinumtoxinA Injection on Myalgia and Arthralgia in Patients Undergoing Temporomandibular Joint Arthroscopy: A Randomized Controlled Trial. Toxins, 15.","DOI":"10.3390\/toxins15060376"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1054\/ijom.2003.0371","article-title":"Five-year retrospective evaluation of temporomandibular joint arthrocentesis","volume":"32","author":"Alpaslan","year":"2003","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.bjoms.2012.01.004","article-title":"Prospective outcome assessment of the therapeutic benefits of arthroscopy and arthrocentesis of the temporomandibular joint","volume":"50","author":"Ahmed","year":"2012","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/0278-2391(91)90409-F","article-title":"Temporomandibular joint arthrocentesis: A simplified treatment for severe, limited mouth opening","volume":"49","author":"Nitzan","year":"1991","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.tripleo.2007.07.003","article-title":"Is there a role for arthrocentesis in recapturing the displaced disc in patients with closed lock of the temporomandibular joint?","volume":"105","author":"Sembronio","year":"2008","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajoms.2021.06.009","article-title":"Current role of arthrocentesis, arthroscopy and open surgery for temporomandibular joint internal derangement with inflammatory\/degenerative disease; -pitfalls and pearls","volume":"34","author":"Murakami","year":"2022","journal-title":"J. Oral Maxillofac. Surg. Med. Pathol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1053\/joms.2001.21001","article-title":"Surgical arthroscopy as the preferred treatment for internal derangements of the temporomandibular joint","volume":"59","author":"Indresano","year":"2001","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/201010581202100112","article-title":"A Retrospective Study of Temporomandibular Joint Internal Derangement Treated with Arthrocentesis and Arthroscopy","volume":"21","author":"Tan","year":"2012","journal-title":"Proc. Singap. Healthc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1016\/0278-2391(92)90047-4","article-title":"Temporomandibular joint arthroscopy: A 6-year multicenter retrospective study of 4,831 joints","volume":"50","author":"McCain","year":"1992","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1054\/jcms.1999.0103","article-title":"Improvement of pain and function after arthroscopy and arthrocentesis of the temporomandibular joint: A comparative study","volume":"28","author":"Goudot","year":"2000","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.coms.2017.09.002","article-title":"Development of the Pediatric Temporomandibular Joint","volume":"30","author":"Bender","year":"2018","journal-title":"Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.joms.2014.12.013","article-title":"Is Anterior Disc Displacement without Reduction Associated with Temporomandibular Joint Condylar Height in Juvenile Patients under 20y","volume":"73","author":"Zhuo","year":"2014","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.jcms.2016.01.019","article-title":"Will unilateral temporomandibular joint anterior disc displacement in teenagers lead to asymmetry of condyle and mandible? A longitudinal study","volume":"44","author":"Xie","year":"2016","journal-title":"J. Cranio-Maxillo-Facial Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.joms.2019.07.011","article-title":"Is Temporomandibular Joint Arthroscopy Effective in Managing Pediatric Temporomandibular Joint Disorders in the Short- and Long-Term?","volume":"78","author":"Choi","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s10006-020-00901-3","article-title":"Arthrocentesis versus glucocorticosteroid injection for internal derangement of temporomandibular joint","volume":"25","author":"AbdulRazzak","year":"2021","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.pmn.2023.04.006","article-title":"OnabotulinumtoxinA for Pediatric Migraine","volume":"24","author":"Karian","year":"2023","journal-title":"Pain Manag. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e551","DOI":"10.1097\/BPO.0000000000001230","article-title":"Evidence-based Recommendations for Pediatric Orthopaedic Practice","volume":"38","author":"Mulpuri","year":"2018","journal-title":"J. Pediatr. Orthop."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/joor.12180","article-title":"apenic consequences of botulinum toxin injections in the masticatory muscles: A pilot study","volume":"41","author":"Raphael","year":"2014","journal-title":"J. Oral Rehabil."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1007\/s11916-009-0050-9","article-title":"Temporomandibular disorders and migraine chronification","volume":"13","author":"Lipton","year":"2009","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_46","unstructured":"AAPD (2019). The Reference Manual of Pediatric Dentistry, American Academy of Pediatric Dentistry."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1002\/2327-6924.12322","article-title":"Jaw disorders in the pediatric population","volume":"28","author":"Horton","year":"2016","journal-title":"J. Am. Assoc. Nurse Pract."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"308","DOI":"10.5005\/jp-journals-10005-2520","article-title":"Prevalence of Oral Parafunctional Habits in Children and Related Factors: An Observational Cross-sectional Study","volume":"16","author":"Mehdipour","year":"2023","journal-title":"Int. J. Clin. Pediatr. Dent."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e20190608","DOI":"10.1590\/1678-7757-2019-0608","article-title":"Temporomandibular disorder, body pain and systemic diseases: Assessing their associations in adolescents","volume":"28","author":"Braido","year":"2020","journal-title":"J. Appl. Oral Sci. Rev. FOB"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/3\/672\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:48:30Z","timestamp":1760104110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/3\/672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,24]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["jcm13030672"],"URL":"https:\/\/doi.org\/10.3390\/jcm13030672","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,24]]}}}