Is single puncture arthrocentesis superior to double puncture arthrocentesis in TMJ disc displacement without reduction?

Abstract

Purpose: The aim of the study was to compare the effectiveness of single puncture arthrocentesis type-1 (SPA Type-1) and double puncture arthrocentesis (DPA) in patients with disc displacement without reduction (DDwoR) of the temporomandibular joint (TMJ). Materials and Methods: This randomized prospective study included 36 consecutive patients who had TMJ arthrocentesis either with DPA or SPA Type-1. Several outcome parameters, such as pain on function, maximum mouth opening, and chewing efficiency were recorded at baseline and multiple follow-up assessments. Additionally, treatment tolerability, easiness and duration of the procedures and analgesics required postoperatively were also evaluated. The difference between the groups at each time point and percentages of sixth month-baseline changes were determined by the Mann-Whitney U test. Wilcoxon test was used for intra-group evaluation of variables according to baseline. Statistical significance level was accepted as p <0.05. Results: The rates of improvement of the outcome variables were not significantly different between the two groups (𝑝>0.05). However, the duration of the DPA technique was significantly shorter than the SPA Type-1 (p˂0.0001). The ease of the procedure was statistically significantly higher in SPA Type-1 (p<0.001). Treatment tolerability was statistically higher in DPA than SPA Type-1 in one day and one-week period however was similar in the one-month period. Conclusion: Both SPA Type-1 and DPA techniques are similarly effective in DDwoR. SPA Type-1 may be considered the first treatment modality in DDwoR due to its advantages over DPA as low morbidity and easiness.