Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up.

Abstract

Aims: To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up.

Methods: A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to manage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. After the treatment cycle, clinical outcomes were assessed based on the following parameters: maximum mouth opening (MO), pain with function (PF), pain at rest (PR), and self-reported chewing efficiency (CE). Data were collected at baseline (T₀) and at successive follow-up assessments, after at least 3 months (T₁) and 1 year (T₂), as per previous publications. Patients who had received treatment at least 10 years prior were then recalled for this study (T₃: 10 to 22 years follow-up). Analysis of variance for repeated measures was performed to assess changes over time.

Results: Significant improvement in all clinical parameters was achieved at T₁ and was maintained for up to 10 years (T₃), with P < .01 for each parameter. At T₃, treatment effectiveness was perceived as excellent by 56% and as good by 26.5% of subjects, while 10.7% perceived a moderate improvement, and 6.8% referred a slight improvement or did not have any improvement. Only seven individuals required additional treatments after T₂.

Conclusion: These findings suggest that the symptomatic management of TMJ DJD achieved in the short or medium term with a cycle of arthrocentesis and viscosupplementation was effectively maintained in the long term.