Arthrocentesis versus nonsurgical methods in the treatment of temporomandibular disc displacement without reduction.
OBJECTIVE
The aim was to compare the short- and medium-term results of arthrocentesis and conventional treatment (splint, heat, and exercise) in patients with early temporomandibular joint (TMJ) disc displacement without reduction (DDw/oR).


METHODS
One hundred twenty consecutive patients (104 female, 16 male), who had been followed by a multidisciplinary TMJ unit with the diagnosis of DDw/oR were enrolled in this single-blind prospective study. Patients either underwent arthrocentesis or they were given a combination of splint, hot pack, and home exercise program. Visual analog scale (VAS) was used for pain assessment. Maximal mouth opening (MMO), lateral movement, and protrusion were measured. Repeat measurements were performed on the first, third, and sixth months following treatments.


RESULTS
Arthrocentesis group consisted of 54 individuals (51 female, 3 male), and the conventional treatment group consisted of 56 individuals (49 female, 7 male). The mean age values of the groups were 33.4 years (range 15-63 years) and 34.8 years (range 17-61 years), respectively. Baseline VAS and MMO values of the arthrocentesis and conventional treatment groups were similar (P > .05). Regarding VAS and MMO, lateral movement, and protrusion, the intragroup analyses showed a statistically significant reduction in both groups compared with baseline values (all P < .01). Regarding VAS values, the difference values between each evaluation and the baseline measurement were significantly higher in the arthrocentesis group, except for the first-month difference. Regarding MMO, lateral movements, and protrusion, the differences between the baseline values and each evaluation thereafter were statistically similar between the 2 groups (P > .05).


CONCLUSIONS
We conclude that early treatment either with conservative methods or with arthrocentesis is beneficial in DDw/oR. However, arthrocentesis seems to be superior regarding pain management. Therefore, arthrocentesis may be indicated in patients where painful complaints overwhelm despite other conservative treatments.
Diraçoğlu
Demirhan
D
Department of Physical Medicine and Rehabilitation, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. demirhan1@yahoo.com
Saral
Ilknur Bayraktar
IB
Keklik
Bariş
B
Kurt
Hanefi
H
Emekli
Ufuk
U
Ozçakar
Levent
L
Karan
Ayşe
A
Aksoy
Cihan
C
D000293:Adolescent; D000328:Adult; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007552:Isotonic Solutions / Q000627:therapeutic use; D004204:Joint Dislocations / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017090:Occlusal Splints; D010147:Pain Measurement; D019152:Paracentesis / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D000077325:Ringer's Lactate; D016037:Single-Blind Method; D019224:Temporomandibular Joint Disc / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
D007552:Isotonic Solutions; D000077325:Ringer's Lactate