Objective: Compare the outcomes of single-needle temporomandibular joint (TMJ) arthrocenthsis (SNA) performed only once under local anaesthesia (LA) to two-needle TMJ arthrocenthesis (TNA) performed under general anaesthesia (GA) followed by hyaluronic acid injection in the arthrogenic temporo-mandibular joint disorders (TMD) patients.
Method: Patients with TMD seen between august 2008 till December 2012 were sub classified into myogenic or arthrogenic based on the research diagnostic criteria for TMD (RDC/TMD). Only the arthrogenic TMD subdivisions patients with sever pain (as assessed by VAS (Visual Analogue of Pain)) and sever jaw dysfunction (as assessed by Helkimo index) were offered SNA done under LA (group 1) or TNA done under GA (group 2) with the injection of 1 ml of hyaluronic acid in both. Improvement was considered to be good if pain and jaw dysfunction improved from being severe to be mild or none. Minimal review was 3 months. Chi-square test was used to compare the outcomes of the two groups.
Results: 175 patients fit the inclusion criteria, 89 patients for group 1 and 86 patients for group 2. The male:female ratio and age group were similar in both groups. Average age was 33 years (range: 20–58 years). There was a significance female predominance with M:F ratio of 1:7.3. Patients with improved of pain and jaw dysfunction accounted for 75% (66/89) of the first group and 68% (58/86) of patients in second group. There was no significant statistical difference between the outcomes of single-needle arthrocenthsis to two-needle arthrocenthesis of the temporo-mandibular joints ( p = 0.529).
Conclusion: Single-needle arthrocentesis under LA with HA injection can do as good as two-needle arthrocentesis under GA with HA injection.
Key words: single needle arthrocentesis; two needle arthrocentesis; TMD