Arthrocentesis techniques used in the treatment of temporomandibular disorders: Literature review.

OBJECTIVE

The article presents a systematic overview of single- and double-puncture techniques of arthrocentesis methods published in the Scopus database during 2016-2020, highlighting the advantages and shortcomings of different methods.

MATERIALS AND METHODS

A search was conducted in the Scopus database using the terms "TMJ OR temporomandibular OR mandibular OR jaw AND arthrocentesis". Arthrocentesis techniques were described and categorized mostly as single- or double-needle ones.

RESULTS

The literature reviewed in the article represents studies of arthrocentesis treatment in 2675 patients involving 2740 joints. Arthrocentesis techniques can mainly be divided into single- and double-needle techniques. Single-needle techniques are subcategorized into type 1 and type 2, of which the first is a single-needle cannula technique where inflow and outflow pass through the same lumen, while the second uses a Y-shaped device, which has two ports and two lumens. Double needle techniques use two needles - one for the inflow and the other for the outflow. The literature found in the Scopus database during the period investigated presents 28% of single-puncture (type 1 - 10%, type 2 - 15%, single puncture with distention of the upper joint compartment - 3%), 69% of double-puncture, 1% of ancillary second-puncture methods and 1% employing a CBCT-based tragus-supported guide with 3 needles.

CONCLUSION

All of the arthrocentesis techniques described in the literature are effective as treatment modalities, none appears to be superior to others. The selection of the method to be used depends on the surgeon´s choice and experience.