3D PRINTED COMPUTER GUIDED Vs CONVENTIAL ARTHROCENTESIS IN THE MANAGEMENT OF TEMPOROMANDIBULAR JOINT INTERNAL DERANGEMENT

INTRODUCTION: Temporomandibular disorder (TMD) is a general term that comprises a wide range of clinical problems involving orofacial muscles and joints with the help of patient specific guide we do arthrocentesis as a non-invasive treatment. OBJECTIVE: The aim of this study was to evaluate the efficiency of 3D printed patient customized guides in conjugation with arthrocentesis in treatment of internal derangement of temporomandibular joint followed by PRP injection. MATERIALS AND METHODS: A total of 20 patients were divided into two groups. In group I patients with internal derangement were managed with patient specific guide to perform arthrocentesis in comparison with the conventional technique that was used in group II. The pain intensity, maximum inter-incisal opening and range of jaw movement in lateral and protrusion movement, joint noise, number of needle relocation and duration of the procedure were assessed. RESULTS: No needle relocation was required in the study group in contrast to the control group, with a statistically significant difference (p=0.030). The difference in the operation duration between both groups was statistically significant(p=0.003), with the study group requiring shorter time to conduct the procedure. A statistically insignificant difference was reported regarding the pain intensity, disturbance in jaw function, maximum inter-incisal opening, range in jaw movement, and joint noise. CONCLUSION: It may be concluded from the results of this study that a computer guided patient specific arthrocentesis guide based on a preoperative CT-scan is a reliable and reproducible method for accurate and more robust conduction of the arthrocentesis procedure with minimal modifications and low complication rate.