Is arthrocentesis of temporomandibular joint with corticosteroids beneficial? A systematic review

Abstract

BackgroundTemporomandibular disorders (TMDs) are musculoskeletal conditions that can inhibit the normal function of temporomandibular joints (TMJs) and affect the patient’s quality of life, negatively. Arthrocentesis (AC) is a minimally invasive surgical procedure used for treating TMDs. The aim of present paper is to evaluate the advantages of administrating corticosteroid (CS) during AC by reviewing high quality released articles.Material and MethodsSearching on Cochrane Library, Web of Science, Google Scholar, PubMed, ProQuest, and Scopus databases were performed with focusing on proper key words. Related titles and abstracts, up to December 2017, were screened and selected based on inclusion criteria. The full text of all randomized controlled trials (RCTs) was extensively read and subjected to quality assessments.ResultsAfter initial search, a total of 2067 articles were included into the study. Finally, 7 studies were reliable enough in methodology and randomization to be included into the study. All of the observed studies showed improvements in jaw functions and pain relief with no statistical differences in both AC and control groups. One study reported painless maximum incisal opening in CS group than the control group.ConclusionsBased on available RCTs, the AC of TMJ with CS seems to result in similar findings to other therapeutic drugs, with no significant differences. Key words:Arthrocentesis, corticosteroid, temporomandibular joints, temporomandibular joint disorders.

The use of arthrocentesis in patients with temporomandibular joint disc displacement without reduction

“…The arthrocentesis technique was introduced at about 30 years ago [8] and it has been largely used along with other treatments, such as infiltrations of sodium hyaluronate [12], intra-articular analgesics [13], corticosteroids [14] and platelet rich plasm [15]. However, the literature has showed that an investigation regarding the isolated effects of the arthrocentesis over the DDWOR along with a clinical analysis performed with the aid of the Magnetic Resonance Imaging (MRI) may elucidate some of the benefits of this therapy.…”

Morphological changes in temporomandibular joint dysfunction and effectiveness of different treatment methods

“…[33] The most common complaint that causes the patient to refer to the physician in TMD is pain, and clinical outcome is the accompanying limitation in jaw movements. [2,14,27] These two factors negatively affect the daily lives of individuals. Reducing pain and limitation are of the most important goals in treatment of TMD.…”

“…Distance between superior and inferior incisive teeth's midpoint was taken as reference for this measurement. [2] MRI images were obtained with a 1.5 T MR imaging system (Philips Achieva; Philips Medical Systems, Best, the Netherlands) with a surface array coil. Proton density weighted (PDW) turbo spin echo sequences were taken in the sagittal plane in the closed-opened mouth position and in the coronal-sagittal plane in the closed mouth position.…”

Pain Management in Temporomandibular Disorders: A Review of the Literature

“…Other studies have investigated the injection of corticosteroids with local anesthesia into the joint and reported good results in terms of pain management and improvement of function [53]. The corticosteroids commonly used intra-articular are betamethasone, methylprednisolone, dexamethasone and triamcinolone [54]. Corticosteroids suppress the inflammatory process inside the joint via prevention of the expression of cytokines and inflammatory mediators through binding to specific receptors [51].…”