Influencing factor on the prognosis of arthrocentesis

Abstract

ObjectivesThe purpose of this article is to evaluate factors influencing prognosis of arthrocentesis in patients with temporomandibular joint (TMJ) disorder.Materials and MethodsThe subjects included 145 patients treated with arthrocentesis at the Dental Center of Ajou University Hospital from 2011 to 2013 for the purpose of recovering mouth opening limitation (MOL) and pain relief. Prognosis of arthrocentesis was evaluated 1 month after the operation. Improvement on MOL was defined as an increase from below 30 mm (MOL ≤30 mm) to above 40 mm (MOL ≥40 mm), and pain relief was defined as when a group with TMJ pain with a visual analog scale (VAS) score of 4 or more (VAS ≥4) decreased to a score of 3 or more. The success of arthrocentesis was determined when either mouth opening improved or pain relief was fulfilled. To determine the factors influencing the success of arthrocentesis, the patients were classified by age, gender, diagnosis group (the anterior disc displacement without reduction group, the anterior disc displacement with reduction group, or other TMJ disorders group), time of onset and oral habits (clenching, bruxism) to investigate the correlations between these factors and prognosis.ResultsOne hundred twenty out of 145 patients who underwent arthrocentesis (83.4%) were found to be successful. Among the influencing factors mentioned above, age, diagnosis and time of onset had no statistically significant correlation with the success of arthrocentesis. However, a group of patients in their fifties showed a lower success rate (ANOVA P=0.053) and the success rate of the group with oral habits was 71% (Pearson's chi-square test P=0.035).ConclusionFrom this study, we find that factors influencing the success of arthrocentesis include age and oral habits. We also conclude that arthrocentesis is effective in treating mouth opening symptoms and for pain relief.

Clinical and intra‐operative factors affecting the outcome of arthrocentesis in disc displacement without reduction: A retrospective study

“…Similarly, Kim et al found that the success rate of arthrocentesis in patients in their fifties or older is likely to be low. Their results were consistent with the previous studies of Von Korff et al and Attia et al On the contrary, Nishimura et al found no significant relationship between the age and the success rate of the arthrocentesis . Consistent with the Nishimura et al, we found no correlation between the age and the success of the procedure.…”

“…Studies show that bruxism is more common among TMD patients than in healthy subjects . Parafunctional habits were also found to be a prognostic factor that influences the outcome of arthrocentesis . Kim et al suggested that patients with parafunctional habits are more likely to fail after an arthrocentesis procedure .…”

“…30 Parafunctional habits were also found to be a prognostic factor that influences the outcome of arthrocentesis. 16 Kim et al suggested that patients with parafunctional habits are more likely to fail after an arthrocentesis procedure. 16 In contrast, we did not find the presence of bruxism as a contributing factor in the success of arthrocentesis.…”

“…16 Kim et al suggested that patients with parafunctional habits are more likely to fail after an arthrocentesis procedure. 16 In contrast, we did not find the presence of bruxism as a contributing factor in the success of arthrocentesis. However, in our study group, all patients used stabilisation splints after arthrocentesis.…”

“…Several clinical and radiological studies have investigated the possible pre‐operative and intra‐operative factors affecting the outcomes of the procedure. Age, duration of the disorder, the severity of the pain, amount of maximum mouth opening (MMO), the presence of degenerative changes on MRIs were found to be the most significant factors affecting the treatment outcome . The effects of intra‐operative variations to the outcome have also investigated widely in the arthrocentesis treatment.…”