Department of Oral and Maxillofacial Surgery, Istanbul Medical School, Istanbul University, 34452 İstanbul, Türkiye.
Medicina (Kaunas). 2023 Oct 4;59(10):1767. doi: 10.3390/medicina59101767.
: Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular diseases involving the temporomandibular joint complex and the surrounding muscle and osseous structure. TMD can be classified as intra-articular or extra-articular. The aim of this study was to evaluate the effect of arthrocentesis in terms of maximum mouth opening (MMO) and pain in patients with TMD of intra-articular origin. In addition to this treatment, the effects of factors such as splints, medication, and physical therapy on arthrocentesis were examined. : This retrospectively designed study was conducted with 79 patients who had previously undergone arthrocentesis. These patients were divided into three groups according to the Research Diagnostic Criteria for temporomandibular disorder: disc displacement (DD) with locking (Group 1), DD without locking (Group 2), and degenerative joint diseases (Group 3) groups. The maximum mouth opening (MMO) and visual analog score (VAS) values of the groups were recorded before arthrocentesis (Baseline: T0), on the third day after arthrocentesis (T1), and at the sixth month (T2) after arthrocentesis. Information about whether the patients received concurrent medical treatment, splint treatment, and physical therapy was also recorded. These data were compared between groups. : It was observed that the VAS scores in all three groups decreased from T1 compared to T0 ( < 0.05). Likewise, the MMO value increased in all groups at T1 compared to T0. ( < 0.05). It was observed that splint treatment, pain killer and muscle relaxant treatment, and physical therapy made no additional contribution to arthrocentesis in terms of reducing pain or increasing MMO value ( > 0.05). : Arthrocentesis was observed to be effective in terms of pain and function in TMJ patients in this study. It was observed that splint therapy, physical therapy, and medical therapy made no additional contribution to arthrocentesis in terms of MMO or pain.
颞下颌关节紊乱（TMD）是一组涉及颞下颌关节复合体及其周围肌肉和骨骼结构的肌肉骨骼和神经肌肉疾病。TMD 可分为关节内或关节外。本研究的目的是评估关节穿刺术对关节内起源的 TMD 患者的最大张口度（MMO）和疼痛的影响。除了这种治疗方法外，还检查了夹板、药物和物理治疗等因素对关节穿刺术的影响。
这项回顾性设计的研究纳入了 79 名先前接受过关节穿刺术的患者。这些患者根据颞下颌关节紊乱的研究诊断标准分为三组：关节盘移位伴（DD）锁结（组 1）、关节盘无锁结（DD）（组 2）和退行性关节病（组 3）。记录各组患者在关节穿刺术前（基线：T0）、关节穿刺术后第 3 天（T1）和术后第 6 个月（T2）的最大张口度（MMO）和视觉模拟评分（VAS）值。还记录了患者是否同时接受药物治疗、夹板治疗和物理治疗的信息。对这些数据进行了组间比较。
结果显示，三组患者的 VAS 评分均从 T1 较 T0 下降（<0.05）。同样，三组患者在 T1 时的 MMO 值均较 T0 增加（<0.05）。结果显示，在减轻疼痛或增加 MMO 值方面，夹板治疗、止痛药和肌肉松弛剂治疗以及物理治疗对关节穿刺术没有额外贡献（>0.05）。
在本研究中，关节穿刺术在颞下颌关节患者的疼痛和功能方面是有效的。夹板治疗、物理治疗和药物治疗对 MMO 或疼痛无额外的关节穿刺术贡献。
