Ungor Cem, Atasoy Kerem Turgut, Taskesen Fatih, Pirpir Cagasan, Yilmaz Onur
*Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University †Private Practice, Trabzon, Turkey.
J Craniofac Surg. 2015 Oct;26(7):2104-8. doi: 10.1097/SCS.0000000000002078.
Arthrocentesis is a minimally invasive procedure used to manage temporomandibular joint (TMJ) internal derangement (ID). This study evaluated the outcome of arthrocentesis in patients with Wilkes stage II and III TMJ ID.
This retrospective study enrolled 50 patients who underwent arthrocentesis in 2011 and 2012 at the Karadeniz Technical University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey. In total, 43 patients underwent unilateral arthrocentesis, whereas 7 patients had bilateral arthrocentesis. The clinical parameters recorded were pain (visual analogue scale [VAS] 0-100 mm during movement), chewing function efficacy (VAS 0-100), clicking sounds, and mandibular movements, including maximum interincisal opening (MIO), lateral excursion, and protrusion. All the parameters were recorded preoperatively, and 1, 3, 6, and 24 months after treatment.
The MIO, lateral excursion, and protrusion were significantly greater than preoperatively in all the patients. Pain declined significantly postoperatively. The patients in Wilkes III group had greater improvement in mandibular movement and pain than the patients in Wilkes II group.
Arthrocentesis was reliable for treating both Wilkes II and III TMJ ID, and the treatment results were better in Wilkes III patients.
关节穿刺术是一种用于治疗颞下颌关节（TMJ）内紊乱（ID）的微创手术。本研究评估了Wilkes II期和III期TMJ ID患者关节穿刺术的治疗效果。
本回顾性研究纳入了2011年和2012年在土耳其特拉布宗技术大学牙科学院口腔颌面外科接受关节穿刺术的50例患者。其中，43例患者接受单侧关节穿刺术，7例患者接受双侧关节穿刺术。记录的临床参数包括疼痛（运动时视觉模拟量表[VAS] 0 - 100 mm）、咀嚼功能效能（VAS 0 - 100）、弹响以及下颌运动，包括最大切牙间开口度（MIO）、侧方运动和前伸运动。所有参数均在术前以及治疗后1、3、6和24个月记录。
所有患者的MIO、侧方运动和前伸运动均显著大于术前。术后疼痛显著减轻。Wilkes III组患者在下颌运动和疼痛方面的改善程度高于Wilkes II组患者。
关节穿刺术治疗Wilkes II期和III期TMJ ID均可靠，且Wilkes III期患者的治疗效果更佳。
