Single puncture versus standard double needle arthrocentesis for the management of temporomandibular joint disorders: A systematic review

Abstract

The aim of this systematic review was to investigate the current evidence in order to assess the efficacy of single puncture arthrocentesis vs standard double needle arthrocentesis in the management of temporomandibular joint(TMJ) disorders. An electronic search of the PubMed, Scopus, Cochrane CENTRAL and Google Scholar databases was performed to identify English studies published up until October 2017. Eligible studies were selected based on inclusion criteria and included randomised controlled trials(RCTs) comparing single puncture arthrocentesis and standard double needle arthrocentesis for the management TMJ disorders. The initial screening identified 984 records, of which only 5 fulfilled the inclusion criteria. A high degree of heterogeneity was found in the 5 studies with each reporting different sample selection and arthrocentesis protocol. All 5 studies reported no difference in reduction in pain intensity and improvement in maximal mouth opening between the single puncture technique and standard double needle technique. This review provides some evidence that single puncture arthrocentesis is clinically as efficacious as standard double needle arthrocentesis. There is a need of well-designed RCT with standard protocol of arthrocentesis comparing different single puncture techniques and standard double needle technique for the management of TMJ disorders.

A Comparative Study Between Concentric Single-Needle Puncture Technique and Conventional 2-Needle Technique for Temporomandibular Joint Arthrocentesis Plus Corticosteroid Injections

“…The article of Senturk et al focuses mainly on the surgeons’ perspective and lacks details on the patient evaluation. Even a meta-analysis by Nagori et al 14 analyzed 5 trials on these techniques and found that both techniques were equally significant in TMJ disorders.…”

Do intra‐articular injections of analgesics improve outcomes after temporomandibular joint arthrocentesis?: A systematic review and meta‐analysis

“…Studies on patients with painful TMJ have implicated the presence of eicosanoids like PGE 2 and leukotriene B 4 as the reason for arthralgia 25 . In this context, arthrocentesis is thought to improve outcomes of TMDs by flushing out inflammatory mediators and reducing the joint vacuum thereby improving the lubrication of the joint 26 . To supplement the efficacy of the procedure, clinicians have also injected several drugs at the end of TMJ arthrocentesis like corticosteroids, sodium hyaluronate, platelet‐rich plasma, and analgesics 5‐7 .…”

Comparison of outcomes with the single‐puncture and double‐puncture techniques of arthrocentesis of the temporomandibular joint: An updated systematic review and meta‐analysis

“…Over the last three decades, many researchers have described their experience with their procedure for the management of various temporomandibular joint disorders (TMDs). 2 Arthrocentesis is usually employed as the first invasive therapy in patients not responding to other conservative modalities like anti-inflammatory drugs, physical therapy or occlusal splint therapy. 3 The procedure involves thorough irrigation of the upper joint compartment by the introduction of needles or cannulas into the TMJ.…”

“…[9][10][11][12] In 2018, we had conducted a systematic review of such comparative studies but were able to include only five studies. 2 We had recommended further trials to explore the differences between the two techniques. By means of the current study, we aimed to update our previous review and compare intra-operative and postoperative outcomes between the two single-puncture and the standard double-puncture techniques of arthrocentesis.…”