Efficacy of Arthrocentesis for Treatment of Internal Post-Traumatic Temporomandibular Joint Disorders

Abstract

The aim: To study the consequences of temporomandibular joint injury and efficacy of arthrocentesis for treatment of post-traumatic internal temporoman¬dibular disorders. Materials and methods: 24 patients who experienced trauma history in the head without jaw fractures underwent CT, ultrasound and/or MRI. TMJ ar¬throcentesis was performed according to a modified method of D. Nitzan (1991) under local anesthesia by means of blockade of the peripheral branch of the auricular-temporal nerve on the background of intravenous sedation. Results: The ages of the patients varied between 18 and 44 years, and mean was 32,58 years. The causes of trauma were diverse, as traffic accident – 3 (12,5%), assault 12 (50%), hit by materials 3 (12, 5%), and fall-down 6 (25%). According to clinical and radiological signs after traumatic temporomandibular disorders, patients were divided into two groups according to Wilkes classification (1989): 13 patients with stage II (early-middle) and 11 - with stage III (middle).The control ultrasound and MRI carried out 3-6 months after arthrocentesis showed no signs of hemarthrosis in 84.61% of patients with intra-articular disorders of the second degree, and in 72.72% of patients with internal disorders of the third degree, the position and function of the articular disc was restored. Conclusions: Arthrocentesis with TMJ lavage is a minimally invasive surgical manipulation that has proven itself in temporomandibular disorders of traumatic origin, in particular after fractures of the articular process of the mandible.

Progress in the Study of Temporomandibular Joint Lavage in Temporomandibular Joint Disorder

“…Temporomandibular joint lavage is mainly used for temporomandibular joint disorders, such as post-traumatic arthritis of the temporomandibular joint, synovial chondromatosis of the temporomandibular joint, fracture of the temporomandibular joint, chronic atresia, which has poor effect on injection treatment, serious pain, and joint cavity exudation. [41][42][43][44][45] This is especially true for synovitis and osteoarthritis, which are not effective with physical therapy alone. But when conservative treatment is invalid or ineffective in patients with severe dysfunction, imaging examination in patients with temporomandibular joint structure obvious change or the temporomandibular joint organization has obvious physical damage, patients with temporomandibular disorders who are unable to live or work normally need timely surgical treatment.…”