Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ) disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO), joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar’s test was used to evaluate CBCT and MRI changes ( ). Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512. 1. Introduction Temporomandibular disorders (TMDs) represent a wide range of functional changes and pathological conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and other components of the oromaxillofacial region. In recent years, TMD has become a frequent cause for seeking medical assistance. The number of patients with TMDs is increasing, probably due to psychological tension in modern society [1]. According to well-accepted psychophysiological concepts, occlusal problems and emotional stress are the most serious aetiological factors [2–7]. However, the causes of TMD are far more complex. A comprehensive understanding requires consideration of the whole masticatory apparatus and the intra-articular situation. Due to the largely nonspecific nature of initial problems, patients are not typically referred to specialists until symptoms have evolved and, in many cases, after irreversible morphological and functional changes have occurred. Characteristic symptoms of TMJ disorders include pain, changes in mandibular mobility (reduced mouth opening (hypomobility) or, in contrast, hypermobility and luxation), clicking, and grinding. TMJ disorders may be treated conservatively or surgically. Conservative treatments include the use of