title: An image-guided technique for puncture of the superior temporomandibular joint cavity: clinical comparison with the conventional puncture technique.
abstract: OBJECTIVE
  The objective of this study was to compare an image-guided puncture technique (IGPT) with conventional puncture technique (CPT) with respect to accuracy of needle entry, maximal mouth opening, and pain in pumping manipulation treatment of internal derangement of the temporomandibular joint (TMJ).
  
  
  METHODS
  The subjects comprised 178 patients with internal derangement of the TMJ with closed lock. Treatment was provided using CPT in 102 cases and IGPT in 76 cases. Three variables, number of repunctures, maximal mouth opening distance, and pain threshold according to a visual analogue scale, were measured and compared between IGPT and CPT groups.
  
  
  RESULTS
  Access to the superior joint cavity was achieved without correcting the puncture point in 97% of patients who underwent IGPT and 82% of patients in the CPT group. Significant differences were seen in 1-week maximal mouth opening and pain threshold between IGPT and CPT groups (P < .05 each) and resetting of the puncture point was significantly less frequent using IGPT compared with CPT (P < .05).
  
  
  CONCLUSIONS
  IGPT is effective for pain mitigation and improves mouth opening during the early postoperative period after pumping manipulation treatment.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Nihon University, School of Dentistry, Tokyo, Japan. matsumoto@dent.nihon-u.ac.jp
authors.forename: Kunihito
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Tore
authors.initials: T
authors.lastname: Bjørnland
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kai
authors.forename: Masahiko
authors.initials: M
authors.lastname: Honda
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yonehara
authors.forename: Kazuya
authors.initials: K
authors.lastname: Honda
mesh_terms: D000293:Adolescent; D000328:Adult; D001175:Arthrography; D054893:Cone-Beam Computed Tomography; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010173:Palpation; D011677:Punctures / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult