Can protrusive movements during TMJ arthrocentesis improve final results?

Abstract

This study aimed to evaluate and compare the efficacy of single-puncture techniques in temporomandibular joint (TMJ) arthrocentesis for the management of disk displacement without reduction (DDwoR). A total of thirty-six patients diagnosed with DDwoR were randomly and blindly assigned to two treatment groups (N = 18 each): Group 1 underwent TMJ arthrocentesis using a concentric needle-cannula system with protrusive movements, while Group 2 received TMJ arthrocentesis with a concentric needle-cannula system but without protrusive movements. The following variables were recorded and compared between the groups: maximal interincisal distance (MID - mm), patient pain perception (visual analogue scale - VAS [0-10]), and operation duration (OP - minutes). Patients in Group 1 exhibited significantly greater MID values after 1 year compared to Group 2 (p<0.001). Both techniques of TMJ arthrocentesis significantly reduced pain perception, with no significant difference between the groups. Additionally, no significant difference in OP was observed between the groups. TMJ arthrocentesis, with or without protrusive movements, significantly improves maximal interincisal distance. However, the inclusion of protrusive movements led to a greater final MID, though it did not significantly impact other measured variables. This suggests a potential benefit of incorporating protrusive movements in TMJ arthrocentesis.