Clinical Evaluation of Arthrocentesis and Modified Anterior Repositioning Splint in Management of Symptomatic TMJ Internal Derangement

Nasef, Mahmoud Mohammed Mahmoud; Al -Ashmawy, Mohammed Mahgob; Makhlouf, Ahmed Omar

doi:10.21608/aadj.2024.282790.1173

Clinical Evaluation of Arthrocentesis and Modified Anterior Repositioning Splint in Management of Symptomatic TMJ Internal Derangement

Document Type : Original Article

Authors

¹ Oral and maxillofacial surgery

² Department of Oral and Maxillofacial Surgery faculty of dental medicine ,assiut branch..al azhar university

³ department of oral and maxillofacial surgery ,faculty of dental medicine .Al Azhar university Assiut

10.21608/aadj.2024.282790.1173

Abstract

Aim: This study aimed to assess arthrocentesis and a modified anterior repositioning
splint (ARS) as a therapeutic protocol for management of symptomatic internal TMJ
derangement, disc displacement without reduction (DDwoR). Subjects and Methods:
Fifteen female patients (30 joints) had TMJ internal derangement (DDwoR) were
randomly involved in this study. A diagnostic preoperative magnetic resonance
imaging (MRI) was done for all patients to confirm the diagnosis. A modified ARS was
constructed for each patient. All patients in this study underwent arthrocentesis and
wearing a modified ARS. Patients were assessed post-operatively after 1 week, 1 month,
3 months, and 6 months for pain score by visual analog scale (VAS), maximum mouth
opening (MMO), and lateral excursions (right and left). Results: Clinical parameters of
this study showed that pain score means improved from (6.80±1.26) preoperatively to
(1.53±1.06) at the 6th month postoperatively. Also, improvement in MMO means from
(26.67±5.47 mm) preoperatively to (43.11±2.08 mm) at the 6th month postoperatively
was clearly observed. In addition to the obvious improvement in means of the right-side
lateral excursion as it was (7.00±0.87 mm) preoperatively then became (8.07±0.56 mm)
at the 6th month postoperatively, also, the left-side lateral excursion means showed the
same improvement from (6.53±0.90 mm) preoperatively to (8.30±0.56 mm) at the 6th
month postoperatively. A statistically significant differences between all preoperative
means and postoperative means in these clinical parameters were clearly observed in
the study. Conclusion: Arthrocentesis and modified ARS can be considered an efficient
method for reduction of clinical signs and symptoms of DDwoR of TMJ.

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