The use of arthrocentesis for the treatment of osteoarthritic temporomandibular joints.

PURPOSE

The purpose of this retrospective study was to determine the efficacy of arthrocentesis in restoring the functional capacity of osteoarthritic temporomandibular joints (TMJ).

PATIENTS AND METHODS

This study involved 36 patients (29 females, 7 males; age range, 16 to 54 years, mean, 37.36 +/- 14.60 years) presenting with 38 dysfunctional joints that had not responded to conservative treatment. The postarthrocentesis status (follow-up period 6 to 62 months, mean 20.7 +/- 20.5 months) of the TMJs was determined by patient self-evaluation using visual analog scales and clinical examination.

RESULTS

Of the 38 TMJs treated with arthrocentesis, 26 joints reacted favorably to the treatment; pain and dysfunction scores were reduced from 9.86 +/- 0.73 to 3.39 +/- 0.76 and from 11.34 +/- 0.66 to 3.4 +/- 0.69, respectively (P <.001). Self-assessed general improvement/deterioration was +4.90 +/- 2.10 (on a scale of -7 to +7). Maximal mouth opening increased from 24.40 +/- 2.70 mm to 43.20 +/- 3.10 mm (P <.001). Lateral and protrusive jaw movements also increased in magnitude. In 14 patients in whom no improvement was noted, arthrocentesis acted as a diagnostic tool before surgical treatment.

CONCLUSIONS

Arthrocentesis is a safe and rapid procedure that in many instances results in the osteoarthritic TMJs returning to a healthy functional state. Failure of arthrocentesis suggests that the painful limitation is most probably caused by changes such as fibrous adhesions or osteophytes that require surgical intervention for their removal.