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ARTHROCENTHESIS FOR TEMPOROMANDIBULAR JOINT DISODER

Facial and head pains are common symptoms and the etiology is well recognized in the majority of cases. Howerver, in some instances, the complex anatomy and emotional overlay make diagnosis difficult. The key components of any differential diagnosis are a thorough knowledge of the anatomy, including the neurologic and vascular distributions, and a detailed history. Closed locking of the TMJ has been ascribed to internal derangement secondary to anteromedial disk displacement without reduction. Although the true etiologic factor of disk displacement and the process of the development of internal derangement have not been clarified, many clinical, surgical arthrographic, and arthroscopic studies support this concept of the cause. A condition of sudden, severe, and persistent limited mouth opening, which readily responds to arthrocentesis, is postulated to a vacuum between disc and fossa in the upper compartment of the temporomandibular joint. This simple treatment was found to be highly effective in reestablishing normal opening and relieving pain. Thirty-four patients (39 joints) who had sudden-onset, persistent limited mouth opening were subjects of this study. These patients who complained TMD was treated by this arthrocenthesis. The overall improvement, as expressed in pain and dysfunction level was 74.4%, with no recurrence of severe closed lock. So the authour thinks that this arthocenthesis is simple, effective and predictable procedure.