We describe procedures for arthrocentesis based on arthroscopic findings and report the therapeutic usefulness of these procedures in 46 patients with closed lock of the temporomandibular joint.
Arthroscopic examination was done under local anesthesia in the outpatient clinic. An 18-gauge needle and a trocar for a 0.8-mm rod-lens fiberscope were inserted into the anterior and posterior compartments of the upper joint space, respectively. The anterior compartment was then observed with special respect to the presence of adhesion. In joints without adhesion, irrigation was done under low hydraulic pressure. In joints with adhesion, irrigation was performed under sufficient hydraulic pressure (maximum pressure exerted, 40 KPa) to widen the upper joint space. Manipulation was performed after irrigation.
Eight weeks after these two procedures, the range of maximum mouth opening increased from 2 to 20 mm and averaged 10.3 mm in 18 patients without adhesion. In 28 patients with adhesion, the increase in maximum mouth opening ranged 3 to 25 mm and averaged 9.1 mm. There was no significant difference in the increase in maximum mouth opening between these two groups.
