Clinical Evaluation of Arthrocentesis and Modified Anterior Repositioning Splint in Management of Symptomatic TMJ Internal Derangement

Abstract

Aim: This study aimed to assess arthrocentesis and a modified anterior repositioning splint (ARS) as a therapeutic protocol for management of symptomatic internal TMJ derangement, disc displacement without reduction (DDwoR). Subjects and Methods:Fifteen female patients (30 joints) had TMJ internal derangement (DDwoR) were randomly involved in this study. A diagnostic preoperative magnetic resonance imaging (MRI) was done for all patients to confirm the diagnosis. A modified ARS was constructed for each patient. All patients in this study underwent arthrocentesis and wearing a modified ARS. Patients were assessed post-operatively after 1 week, 1 month, 3 months, and 6 months for pain score by visual analog scale (VAS), maximum mouth opening (MMO), and lateral excursions (right and left). Results: Clinical parameters of this study showed that pain score means improved from (6.80±1.26) preoperatively to (1.53±1.06) at the 6th month postoperatively. Also, improvement in MMO means from (26.67±5.47 mm) preoperatively to (43.11±2.08 mm) at the 6th month postoperatively was clearly observed. In addition to the obvious improvement in means of the right-side lateral excursion as it was (7.00±0.87 mm) preoperatively then became (8.07±0.56 mm) at the 6th month postoperatively, also, the left-side lateral excursion means showed the same improvement from (6.53±0.90 mm) preoperatively to (8.30±0.56 mm) at the 6th month postoperatively. A statistically significant differences between all preoperative means and postoperative means in these clinical parameters were clearly observed in the study. Conclusion: Arthrocentesis and modified ARS can be considered an efficient method for reduction of clinical signs and symptoms of DDwoR of TMJ.