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.
OBJECTIVE
The aim of this study is to compare the clinical short-term results and efficacy of arthrocentesis with those of nonsurgical treatments and arthroscopic surgery for the management of temporomandibular joint closed lock.


METHODS
The three groups consisted of 63 consecutive patients treated nonsurgically, 20 patients treated with arthrocentesis, and 25 patients treated with arthroscopic surgery. All patients rated their pain level on a visual analogue scale and completed a pain, jaw dysfunction, and activity-limiting questionnaire before and 6 months after the procedure. Each patient's jaw opening was also scaled. The success rate of each procedure was calculated according to our success criteria. The clinical efficacy of each procedure was evaluated in successfully treated subgroups in which the between-group and within-group differences of the obtained data were statistically tested.


RESULTS
The success rate was 55.6% in the nonsurgically treated group, 70% in the arthrocentesis group, and 91% in the arthroscopy group. With respect to efficacy, all posttreatment scores showed significant improvements in within-group differences, but no between-group differences were found between the arthrocentesis group and the other two groups.


CONCLUSIONS
Arthrocentesis was considered as an intervening treatment modality between nonsurgical treatment and arthroscopic surgery on the basis of its short-term outcome. Although the treatment efficacy was comparable with arthroscopic surgery, this procedure was thought to be indicated for the patients with acute temporomandibular joint closed lock who were refractory to medication and mandibular manipulation rather than the alternative of arthroscopic surgery.
D000203:Activities of Daily Living; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018771:Arthralgia / Q000503:physiopathology; D001182:Arthroscopy; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008334:Mandible / Q000503:physiopathology; D008349:Manipulation, Orthopedic; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D017090:Occlusal Splints; D010147:Pain Measurement; D011677:Punctures; D016059:Range of Motion, Articular; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009125:Muscle Relaxants, Central