Table 1.
Responses among all providers
| Question | Response n (%)* | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| Discectomy is a useful procedure for managing TMJ-ID | 44 (75) | 6 (10) | 6 (10) | 3 (5) | 0 (0) |
| Discectomy is useful as a first surgical option for TMJ-ID | 24 (41) | 20 (34) | 4 (7) | 9 (15) | 2 (3) |
| Discectomy is effective for managing TMJ pain | 15 (26) | 20 (34) | 7 (12) | 9 (16) | 7 (12) |
| Discectomy is effective for managing TMJ locking | 19 (33) | 16 (28) | 10 (17) | 7 (12) | 6 (10) |
| Discectomy is effective if symptoms persist after TMJ arthrocentesis or arthroscopy | 11 (19) | 15 (26) | 13 (22) | 10 (17) | 9 (16) |
| After undergoing TMJ discectomy, most patients have good jaw function and pain control in the long term | 4 (7) | 5 (9) | 19 (33) | 20 (34) | 10 (17) |
| In the management of disc displacement with reduction, discectomy has better outcomes than arthroscopy or arthrocentesis | 18 (32) | 14 (25) | 13 (23) | 6 (11) | 6 (11) |
| In the management of disc displacement without reduction, discectomy has better outcomes than arthroscopy or arthrocentesis | 7 (12) | 9 (15) | 11 (19) | 22 (37) | 10 (17) |
| In the management of disc displacement without reduction and degenerative bony changes, discectomy has better outcomes than arthroscopy or arthrocentesis | 42 (71) | 7 (12) | 4 (7) | 3 (5) | 3 (5) |
| In the management of disc displacement with reduction, discectomy has better outcomes than disc plication (discopexy) | 13 (22) | 7 (12) | 12 (21) | 22 (38) | 4 (7) |
| In the management of disc displacement without reduction, discectomy has better outcomes than disc plication (discopexy) | 8 (14) | 5 (9) | 11 (19) | 23 (40) | 11 (19) |
| Discectomy is effective if symptoms persist after disc plication) | 7 (12) | 5 (9) | 10 (17) | 27 (47) | 9 (16) |
| It is preferable to avoid discectomy and recommend a modified condylotomy if TMJ symptoms persist after conservative measures (may include non-surgical or minimally invasive surgical options) | 7 (12) | 7 (12) | 11 (19) | 25 (42) | 9 (15) |
| An eminectomy should be performed at the time of discectomy | 18 (31) | 15 (25) | 18 (31) | 4 (7) | 4 (7) |
| Osteoplasty of the fossa and/or condyle is usually indicated at the time of discectomy | 19 (32) | 18 (31) | 10 (17) | 11 (19) | 1 (2) |
| Interpositional tissue is indicated in most cases after discectomy | 13 (22) | 11 (19) | 6 (10) | 14 (24) | 15 (25) |
| Interpositional tissue improved pain and function after TMJ discectomy | 11 (19) | 13 (22) | 13 (22) | 13 (22) | 9 (15) |
| A fossa-eminence alloplast should be implanted after discectomy | 44 (75) | 10 (17) | 4 (7) | 0 (0) | 1 (2) |
| The fossa-eminence alloplast improves pain and function after discectomy | 38 (66) | 9 (16) | 10 (17) | 0 (0) | 1 (2) |
| Instead of discectomy, an alloplastic total joint replacement is indicated if TMJ symptoms persist after conservative measures (may include non-surgical or minimally invasive surgical options) | 21 (36) | 17 (29) | 4 (7) | 12 (20) | 5 (8) |
| Discectomy is the procedure of choice before considering alloplastic total joint replacement for patients with symptomatic disc displacement without reduction | 10 (17) | 9 (15) | 6 (10) | 22 (37) | 12 (20) |
| Discectomy is the procedure of choice if the disc is perforated on arthroscopy/MRI and symptoms persist | 10 (17) | 5 (8) | 5 (8) | 22 (37) | 17 (29) |
| Discectomy is the procedure of choice before considering alloplastic total joint replacement for symptomatic patients with late stage TMD-ID and degenerative condylar changes of the TMJ) | 16 (27) | 13 (22) | 6 (10) | 16 (27) | 8 (14) |
| An alloplastic total joint replacement is the procedure of choice if the disc is perforated on arthroscopy/MRI and symptoms persist | 15 (25) | 15 (25) | 11 (19) | 11 (19) | 7 (12) |
| Most patients who undergo TMJ discectomy need additional surgery such as alloplastic total joint replacement | 8 (14) | 15 (25) | 12 (20) | 15 (25) | 9 (15) |
*
1=Strongly disagree; 2=Somewhat disagree; 3=Neither agree nor disagree; 4=Somewhat agree; 5=Strong agree