Does radiofrequency ablation reduce pain and improve maximal incisal opening more effectively than electrocautery in temporomandibular joint arthroscopy? A pilot study

Objective: The study compared the effectiveness of radiofrequency and electrocautery techniques in TMJ arthroscopic surgeries by evaluating changes in pain levels and maximal incisal opening before surgery and throughout a 30-day postoperative period.

Materials and methods: This prospective, randomized controlled trial included 62 patients with bilateral TMJ disorders classified as Wilkes stages III and IV. Patients were randomly assigned to two groups: Group 1 (n = 31) underwent arthroscopy with electrocautery, and Group 2 (n = 31) received radiofrequency ablation. Inclusion criteria were patients with Wilkes stages III or IV TMJ disorders. Exclusion criteria included previous TMJ surgery, significant systemic disease, or contraindications to surgery. Pain levels were assessed using the McGill Pain Questionnaire, and maximal incisal opening was measured preoperatively and up to 30 days postoperatively.

Results: The sample included 62 subjects with a mean age of 33.5 years, 80.6% female. The electrocautery group showed significantly greater maximal incisal opening at 12 h, 7 days, and 14 days post-surgery compared to the radiofrequency ablation group. Pain levels did not differ significantly between groups, though the electrocautery group reported higher pain scores on postoperative day 14. Both groups showed similar pain improvement and maximal incisal opening changes over 30 days, with a trend towards more improvement in maximal incisal opening in the radiofrequency ablation group. No significant differences in complications or overall pain improvement were observed.

Conclusion: Electrocautery and radiofrequency did not differ in postoperative pain outcomes; however, electrocautery was more effective in improving maximal incisal opening up to postoperative day 14.