Single puncture arthrocentesis of temporomandibular joint; introducing a novel device: A pilot study

INTRODUCTION: Arthrocentesis is a method of irrigating the temporomandibular joint (TMJ) with a therapeutic substance. It is usually performed by dual puncture with two needles to the joint space. Several studies have shown that arthrocentesis of the upper compartment of the TMJ may be a highly effective method to restore normal maximal mouth opening and functioning. Nonetheless, the classical two needle technique has some limitations, such as the low tolerability and difficulty in performing it in the presence of intra-articular adherences. The adoption of a single puncture technique for both fluid injection and aspiration might have some advantages with respect to the traditional two needle approach in terms of time of execution, tolerability, and retention of medication. MATERIALS AND METHODS: A single puncture technique with a self fabricated device is used to assess the efficacy of this device. This study involved 20 patients of age ranging between 20- 64 years diagnosed with TMD. Patients follow up done at 3(rd), 14(th), 45(th) and 90(th) day and assessment of pain, mouth opening, clicking and deviation done with comparison of pre and post-operative data. RESULTS: The procedure was successful in all the patients. Most of the patients reported reduction in pain more than half of the previous value and two patients reported only moderate reduction. There was a clinically significant improvement in mouth opening, clicking and deviation. CONCLUSION: Arthrocentesis is effective in treating TMJ internal derangement and restoring its function. Single puncture arthrocentesis, is a minimally invasive, simple, inexpensive & highly efficient procedure that can be performed under local anaesthesia.