Introduction: Minimally invasive surgery (MIS) of the temporomandibular joint (TMJ) is considered the initial surgical treatment of choice in temporomandibular disorders (TMD) that has not responded to conservative treatment. The high effectiveness of arthroscopic surgical advanced techniques versus arthroscopic lysis-lavage technique are still a subject of controversy.

Objectives: To evaluate the effectiveness of lysis-lavage versus operative arthroscopy in the treatment of TMD and evaluate the morbidity of these techniques.

Methods: We performed a retrospective study of the arthroscopies done between 1998 and 2004. They included 310 arthroscopies in 205 patients. 30% of patients underwent arthroscopic lysis-lavage and 70% operative. We evaluated mandibular movements, functional improvement during mastication and pain using a VAS.

Results: Results were good for both types of arthroscopy, with 88% of the patients with excellent or good results. Patients with II or III Wilkes stages went better over the time. The IV and V stages recurred more frequently. In patients with chronic disc locking, the improvement of mouth opening and pain was checked in 90% of cases with both techniques. 5% of the arthroscopies required later arthrotomy.

Conclusions: Effectiveness of TMJ arthroscopy was adequate in both cases of arthroscopy, and we found no significant differences.