Kütük Nükhet, Baş Burcu, Kazan Dilara, Yüceer Ezgi
Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakıf University, Istanbul, Turkey.
Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
J Oral Maxillofac Surg. 2019 Jul;77(7):1359-1364. doi: 10.1016/j.joms.2019.01.041. Epub 2019 Feb 5.
Arthrocentesis is an effective, simple, and minimally invasive treatment in patients with temporomandibular joint (TMJ) closed lock (CL). The aim of this study was to compare the effectiveness of 1- versus 2-session arthrocentesis procedures in the management of TMJ CL.
A retrospective cohort study was conducted using the files of patients with TMJ CL according to diagnostic criteria for temporomandibular disorders. Patients who underwent 1- or 2-session arthrocentesis were included in the study. The decision of whether to undergo 1- or 2-session arthrocentesis was made by the patients: Those who accepted a second arthrocentesis procedure were assigned to group 1 (repeated arthrocentesis group), and those who did not accept, to group 2 (arthrocentesis group). The primary predictor variable was treatment method. TMJ pain (scored on a visual analog scale) and maximum mouth opening (MMO) were selected as the outcome variables. To evaluate the clinical outcomes of 1- or 2-session arthrocentesis, MMO and pain score (on a visual analog scale) before treatment and at 1, 3, and 6 months' follow-up were analyzed. Descriptive, comparative, correlation, and multivariate analyses were conducted.
A total of 30 patients (25 female and 5 male patients) with TMJ disc displacement without reduction were enrolled in the study. Each group consisted of 15 patients. Statistically significant decreases in pain scores and increases in MMO values were observed in both treatment groups at 3 and 6 months (P < .05). At 6 months, MMO values were significantly higher and pain levels were significantly lower in patients who received 2 arthrocentesis procedures.
Repeated arthrocentesis is more successful at reducing pain and improving MMO than a single intervention in the treatment of TMJ CL.
关节穿刺术是治疗颞下颌关节（TMJ）闭锁（CL）患者的一种有效、简单且微创的方法。本研究旨在比较单次与两次关节穿刺术治疗TMJ CL的效果。
根据颞下颌关节紊乱病的诊断标准，对TMJ CL患者的病历进行回顾性队列研究。纳入接受单次或两次关节穿刺术的患者。是否接受单次或两次关节穿刺术由患者决定：接受第二次关节穿刺术的患者被分配到第1组（重复关节穿刺术组），未接受的患者被分配到第2组（关节穿刺术组）。主要预测变量为治疗方法。选择TMJ疼痛（采用视觉模拟评分）和最大开口度（MMO）作为结局变量。为评估单次或两次关节穿刺术的临床效果，分析治疗前及随访1、3和6个月时的MMO和疼痛评分（视觉模拟评分）。进行描述性、比较性、相关性和多变量分析。
本研究共纳入30例TMJ盘移位不可复的患者（25例女性和5例男性）。每组15例患者。在3个月和6个月时，两个治疗组的疼痛评分均有统计学意义的下降，MMO值均有增加（P <.05）。在6个月时，接受两次关节穿刺术的患者MMO值显著更高，疼痛程度显著更低。
在治疗TMJ CL时，重复关节穿刺术在减轻疼痛和改善MMO方面比单次干预更成功。
