Comparing Two-Needle vs. Surgery-Guided Arthrocentesis for TMJ Disorders

A Randomized Controlled Trial Evaluating the Efficacy of Conventional Two-Needle Arthrocentesis Versus Surgery-Guided Arthrocentesis in the Management of Temporomandibular Joint Disorders

The goal of this clinical trial is to compare two methods of arthrocentesis in treating temporomandibular joint (TMJ) disorders. The main questions it aims to answer are:

Is surgery-guided arthrocentesis more efficient in terms of operation time compared to traditional two-needle arthrocentesis? Does the use of surgical guides lead to less postoperative pain and better patient comfort?

Participants will:

Undergo either the traditional two-needle arthrocentesis or the surgery-guided arthrocentesis.

Be monitored for operation time, postoperative pain, and overall patient comfort.

Researchers will compare the outcomes of patients who underwent traditional two-needle arthrocentesis with those who had surgery-guided arthrocentesis to see if the latter can shorten operation time and improve patient comfort.

Inclusion Criteria:

• Patients diagnosed with Wilkes stage II, III, or IV Temporomandibular Joint (TMJ) internal derangement.
• Presence of pain, sound, or both in the TMJ.
• Limitation or locking in mouth opening, or both.
• Patients who have not responded to symptoms after a minimum of three months of splint therapy.

Exclusion Criteria:

• Presence of infection in the puncture area.
• Presence of osteomyelitis in the neighboring region.
• Patients with uncontrolled coagulopathies.
• Patients experiencing limitation in maximum mouth opening without disk disorder.
• Patients with severe degenerative joint disease (e.g., deformed condylar contour, osteophyte findings in MRI).
• History of TMJ surgery.
• History of muscle-originated mandibular hypomobility.