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Arthrocentesis Versus Level 1 Arthroscopy in Internal Derangement of Temporomandibular Joint

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Abstract

Introduction

Internal derangement of the temporomandibular joint is defined as an abnormal position of the articular disc in relation with mandibular condyle and articular eminence presenting as disc displacement with or without reduction.

Methodology

This study was conducted on thirty patients diagnosed with Internal derangement of TMJ consisting of 8 males and 22 females averaging 34.6 years. Two groups Conventional Arthrocentesis (Group A) and Level 1 Arthroscopy (Group B) consisted of 15 cases each divided alternately. Clinical evaluation parameters included VAS for pain, maximal interincisal opening, deviation on mouth opening, range of motion including lateral excursion & protrusion movements recorded at 1 week, 1 month & 6 months postoperatively. Wilke’s Staging according to MRI findings was recorded preoperatively and 6 months postoperatively.

Results

At 6 month follow-up, average reduction in VAS for pain & deviation on mouth opening was 72.43% & 24.73% in Group A and 77.66% & 65.41% in Group B, respectively. Average increase in MIO, right & left excursion & protrusion movements was 29.55%, 31.33%, 20.12% & 32.45% in Group A and 34.94%, 41.37%, 39.29% and 36.51% in Group B, respectively. Improved results were obtained clinically for all Wilke’s stages in both groups with more number of patients improving in Group B.

Conclusion

On comparing results, improvement was observed in various clinical evaluation parameters of both the groups at 6 months follow-up. However, statistically significant & better results were obtained for the Arthroscopy group.

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Abbreviations

ID:

Internal derangement

TMJ:

Temporomandibular joint

MRI:

Magnetic resonance imaging

MIO:

Maximal interincisal opening

VAS:

Visual analog scale

UJS:

Upper joint space

References

  1. Muthukrishnan A, Sekar GS (2015) Prevalence of temporomandibular disorders in Chennai population. J Indian Acad Oral Med Radiol 27:508–515

    Article  Google Scholar 

  2. Karthik R, Hafila MI, Saravanan C, Vivek N, Priyadarsini P, Ashwath B (2017) Assessing prevalence of temporomandibular disorders among university students: a questionnaire study. J Int Soc Prevent Communit Dent 7(Suppl 1):S24–S29

    CAS  Google Scholar 

  3. Israel HA (2016) Internal derangement of the temporomandibular joint: new perspectives on an old problem. Oral Maxillofac Surg Clin N Am 28(3):313–333

    Article  Google Scholar 

  4. Moses JJ. Temporomandibular joint arthrocentesis and arthroscopy: rationale and technique. Peterson’s Princ Oral Maxillofac Surg. 2004;963–88.

  5. Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 1991 Nov;49(11):1163–7; discussion 1168–1170.

  6. Dimitroulis G, Dolwick MF, Martinez A. (1995) Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg. 33(1):23–6; discussion 26–27.

  7. Hosaka H, Murakami K, Goto K, Iizuka T (1996) Outcome of arthrocentesis for temporomandibular joint with closed lock at 3 years follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82(5):501–504

    Article  CAS  Google Scholar 

  8. Dimitroulis G (2012) Temporomandibular joint surgery: what Does it mean to India in the 21st Century? J Maxillofac Oral Surg 11(3):249–257

    Article  Google Scholar 

  9. Alkan A, Baş B (2007) The use of double-needle canula method for temporomandibular joint arthrocentesis: clinical report. Eur J Dent 1(3):179–182

    Article  Google Scholar 

  10. Nitzan DW. (2006) Arthrocentesis--incentives for using this minimally invasive approach for temporomandibular disorders. Oral Maxillofac Surg Clin N Am. 18(3):311–28, vi.

  11. Kaneyama K, Segami N, Nishimura M, Sato J, Fujimura K, Yoshimura H (2004) The ideal lavage volume for removing bradykinin, interleukin-6, and protein from the temporomandibular joint by arthrocentesis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 62(6):657–661

    Article  Google Scholar 

  12. McCain JP, de la Rua H, LeBlanc WG (1991) Puncture technique and portals of entry for diagnostic and operative arthroscopy of the temporomandibular joint. Arthrosc J Arthrosc Relat Surg 7(2):221–232

    Article  CAS  Google Scholar 

  13. McCain JP. Principles and practice of temporomandibular joint arthroscopy. Mosby-Year Book; 1996.

  14. Goudot P, Jaquinet AR, Hugonnet S, Haefliger W, Richter M (2000) Improvement of pain and function after arthroscopy and arthrocentesis of the temporomandibular joint: a comparative study. J Cranio-Maxillofac Surg 28(1):39–43

    Article  CAS  Google Scholar 

  15. Murakami K, Hosaka H, Moriya Y, Segami N, Iizuka T (1995) Short-term treatment outcome study for the management of temporomandibular joint closed lock: a comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80(3):253–257

    Article  CAS  Google Scholar 

  16. Ahuja V, Ranjan V, Passi D, Jaiswal R (2018) Study of stress-induced temporomandibular disorders among dental students: An institutional study. Natl J Maxillofac Surg 9(2):147–154

    Article  Google Scholar 

  17. Rehman K-U, Hall T (2009) Single needle arthrocentesis. Br J Oral Maxillofac Surg 47(5):403–404

    Article  Google Scholar 

  18. Singh S, Shivamurthy DM, Varghese D. Re: Rahal A, et al (2011) Single-puncture arthrocentesis--introducing a new technique and a novel device. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 69(1):311; author reply 312.

  19. Al-Moraissi EA (2015) Arthroscopy versus arthrocentesis in the management of internal derangement of the temporomandibular joint: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 44(1):104–112

    Article  CAS  Google Scholar 

  20. Emshoff R, Rudisch A (2004) Determining predictor variables for treatment outcomes of arthrocentesis and hydraulic distention of the temporomandibular joint. J Oral Maxillofac Surg 62(7):816–823

    Article  Google Scholar 

  21. Israel HA, Behrman DA, Friedman JM, Silberstein J (2010) Rationale for early versus late intervention with arthroscopy for treatment of inflammatory/degenerative temporomandibular joint disorders. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg 68(11):2661–2667

    Article  Google Scholar 

  22. Fridrich KL, Wise JM, Zeitler DL (1996) Prospective comparison of arthroscopy and arthrocentesis for temporomandibular joint disorders. J Oral Maxillofac Surg 54(7):816–820

    Article  CAS  Google Scholar 

  23. Wilkes CH (1989) Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg. 115(4):469–77.

  24. Ahmed N, Sidebottom A, O’Connor M, Kerr H-L (2012) Prospective outcome assessment of the therapeutic benefits of arthroscopy and arthrocentesis of the temporomandibular joint. Br J Oral Maxillofac Surg 50(8):745–748

    Article  Google Scholar 

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Acknowledgements

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Ahmedabad, Gujarat, India

    Dewanshi Rajpoot, Sonal Anchlia, Utsav Bhatt, Jigar Dhuvad, Hiral Patel & Zaki Mansuri

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  1. Dewanshi Rajpoot
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  2. Sonal Anchlia
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  3. Utsav Bhatt
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  4. Jigar Dhuvad
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  5. Hiral Patel
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  6. Zaki Mansuri
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Contributions

Dr. Dewanshi Rajpoot did all preoperative preparations, history taking, postoperative care, proper follow-up, maintained the records & prepared the first draft of the manuscript alongwith subsequent editing & formatting, Dr. Sonal Anchlia performed arthroscopic surgeries, drafted the study conception & design & reviewed the entire paper critically for important intellectual content, revision & editions, Dr. Utsav Bhatt performed the arthrocentesis procedures and contributed to the analysis & writing of this paper. Dr. Jigar Dhuvad reviewed the paper & suggested editions accordingly. Dr. Hiral Patel & Zaki Mansuri positively contributed to write the paper.

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Correspondence to Dewanshi Rajpoot.

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Rajpoot, D., Anchlia, S., Bhatt, U. et al. Arthrocentesis Versus Level 1 Arthroscopy in Internal Derangement of Temporomandibular Joint. J. Maxillofac. Oral Surg. 22, 94–101 (2023). https://doi.org/10.1007/s12663-021-01627-9

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  • DOI: https://doi.org/10.1007/s12663-021-01627-9

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