Abstract
Minimally invasive therapeutic procedures have been applied for the management of degenerative joint disease in the temporomandibular joint (TMJ). This study describes a modified technique of arthrocentesis with concentric needle and cannula in the TMJ associated with viscosupplementation and/or orthobiologics. Its effects were evaluated based on clinical outcomes related to pain, mouth opening, and joint sound, along with longitudinal tomographic evaluation based on the Wilkes classification. A prospective study was conducted with 22 patients (44 TMJs) undergoing arthrocentesis complemented by ultrasonography. The technique allowed effective lavage followed by infiltration into both the upper and lower compartments, using therapeutic agents selected based on the stage of articular temporomandibular disorder (TMD) according to the Wilkes classification. Clinical and tomographic assessments were performed before and after treatment, with follow-up ranging from 12 to 14 months. Significant improvements in pain outcomes (p < 0.001) and mouth opening amplitude (p < 0.001) were observed in all patients. There were no significant changes in joint sound post-treatment. The Wilkes classification revealed a reduction in degenerative stages in both the right (p = 0.003) and the left (p = 0.007) TMJs. The modified arthrocentesis technique combined with viscosupplementation and/or orthobiologics (platelet-rich fibrin) has been shown to be effective in reducing pain and improving TMJ function, suggesting a minimally invasive and safe approach for managing advanced articular TMDs. Future studies are recommended to confirm its applicability in different populations and in individuals with vary stages of TMD.