If pain or locks persist despite several months of conservative therapy or unsuccessful arthrocentesis and lavage in patients with disc displacement, we believe that the next step is to carry out arthroscopic surgery on the temporomandibular joint. This is not something that should be delayed for too long; otherwise the articular disc may become so severely deformed that it is no longer possible to restore the joint to a state in which it can function properly. Furthermore, pain can become chronic after only 6 months (pain memory).

The surgery itself is as follows: first the sharp diathermy probe or laser fibre are used to release the disc from its adhesions with the anterior joint capsule. Any other adhesions that fix the disc to the articular eminence and fossa and that often stretch across the joint space are separated.

Then the surface of the overstretched posterior disc attachment is coagulated in areas with the blunt diathermy probe. The tissue behind the disc that has undergone this treatment can be reduced in size over the weeks to come and bring the disc into a more favourable position.

This surgery generally significantly improves the mobility of the joint and the pain should also be much greatly diminished. The success rate of this minor surgical procedure is over 90%, according to large-scale international studies.