The use of arthrocentesis in patients with temporomandibular joint disc displacement without reduction

Abstract

The aim of this study was to evaluate the efficacy of the use of the arthrocentesis in patients with disc displacement without reduction (DDWOR). Two hundred and thirty-four (234) patients with DDWOR were evaluated and the following data collected: gender; affected side; age (years); duration of the pain (months); patient's perception of pain (measured by Visual Analogue Scale [VAS 0-10]); maximal interincisal distance (MID) (mm); and joint disc position, determined by magnetic resonance imaging. Data were obtained in two different moments: before the arthrocentesis (M1) and three or four months later (M2). Paired t-Student Test, Scores Test and Wilcoxon Test showed a statistical significant difference (p<0.0001) between the M1 and M2 for the variables VAS and MID. There was an alteration in the joint disc position in 93.88% of the cases after arthrocentesis. There was no association between the general characteristics of the patients on the M1 and the results of the arthrocentesis (p>0.05). It can be concluded that the arthrocentesis is efficient in reducing the pain, in increasing interincisal distance, and altering the joint disc position in patients with DDWOR regardless gender, age side and pain duration.

Fig 1

A: reference line and the two points for the insertion of the needles. B: first needle inserted. C: second needle inserted. D: first needle connected with syringe and the second needle connected to a vacuum pump. The physiological solution is administered in the first needle, get into the superior compartment of TMJ and got out by the second needle.

Fig 2. NC example.

A: before the arthrocentesis. B: four months after arthrocentesis.

Fig 3. IPAIC example.

A: before the arthrocentesis. B: four months after arthrocentesis.

Fig 4. MAICD example.

A: before the arthrocentesis. B: four months after arthrocentesis.