Prognostic factors in arthrocentesis of the temporomandibular joint: evaluation of 100 patients with internal derangement.
OBJECTIVE
The goal of this study was to analyze the prognostic factors for successful arthrocentesis for internal derangement (ID) of the temporomandibular joint (TMJ).


METHODS
Arthrocentesis was carried out as the initial treatment in 103 TMJs of 100 patients with ID. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of preoperative pain on a visual analog scale (VAS). Prognostic factors analyzed were age, sex, duration of painful locking, preoperative and postoperative range of MMO, preoperative degree of pain, preoperative clicking on opening mouth before becoming locked, and magnetic resonance imaging (MRI) findings. These factors were statistically analyzed.


RESULTS
Seventy-three cases (71%) satisfied the criteria for success. One week after the procedure, the mean range of MMO in the successful cases (43.8 +/- 5.5 mm) was significantly greater than that in unsuccessful cases (36.9 +/- 6.6 mm) (P <.05). The mean preoperative degree of pain on a VAS in successful cases (4.7 +/- 2.9) was significantly smaller than that in unsuccessful cases (6.2 +/- 2.1) (P <.05). The preoperative incidence of morphologic changes in the mandibular condyle seen on MRI of successful cases was significantly less than that in unsuccessful cases (P <.05).


CONCLUSIONS
Severe preoperative pain, relapse in the amount of mouth opening within 1 week after arthrocentesis, and preoperative bony changes in the condyle may be predictors of the effectiveness of arthrocentesis for ID of the TMJ.
Nishimura
M
M
Received from the Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Japan. maasaki@kanazawa-med.ac.jp
Segami
N
N
Kaneyama
K
K
Suzuki
T
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000627:therapeutic use; D004204:Joint Dislocations / Q000503:physiopathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology; D008875:Middle Aged; D010146:Pain / Q000145:classification; D010147:Pain Measurement; D019152:Paracentesis / Q000379:methods; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D000077331:Ringer's Solution; D012737:Sex Factors; D013016:Sound; D013223:Statistics as Topic; D013704:Temporomandibular Joint / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000473:pathology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
D007552:Isotonic Solutions; D000077331:Ringer's Solution