Title: Arthrocentesis in Internal Derangements of the Temporomandibular Joint- A Clinical Study

Authors: Manoj S, Kavitha Janardanan, Ajith Kumar K, Ashik A

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i12.82

Abstract

Aim: To evaluate whether arthrocentesis, as a treatment modality, is effective in restoring the form, function, and in reducing pain in the Temporomandibular joint (TMJ).

Materials and Methods: Fifteen patients with complaints of sudden, persistent, limited mouth opening and pain stemming from the TMJ were subjected to arthrocentesis. Two 20 G needles were inserted into the superior compartment of the TMJ and 100ml of Ringer’s lactate (RL) was used as the irrigant. The maximum mouth opening and lateral movements were measured.  Pain was assessed using a Visual Analog Scale (VAS) of 100 points. All measurements were made prior to the procedure, immediately after and six months later.

Results: The maximum mouth opening was 25.9± 4.4mm pre operatively which increased to 39± 7.1mm immediately post operatively and to 42.8±7.7mm after a period of six months. This amounts to 52.5% increase immediately post operatively and 65.25% after six months, the percentage increase being 8.53%. The significance of the increase was tested using a paired‘t’ test. The ‘t’ values were 5.90 and 10.23 respectively, indicating that the mean increase in the extent of mouth opening was highly significant even at 0.001 level of significance. The arthrocentesis procedure is definitely helpful in restoring the normal range of motion of the mandible. Pain was measured using VAS. 67% of patients had pain relief immediately post operatively and 73% had 100% pain relief after six months.

Conclusion: Arthrocentesis is a surgical procedure, with high success rate, minimal complications, and is an essential first surgical step in relief of symptoms, prior to arthroscopy and/ or open joint surgery.

Keywords: Temporomandibular Joint Arthrocentesis, TMJ pain, Mouth Opening, Internal derangement of TMJ.

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Corresponding Author

Manoj S

Additional Professor, Department of OMFS,

Govt. Dental College, Thiruvananthapuram, Kerala

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