Are internal derangement and osteoarthrosis linked to changes in clinical outcome measures of arthrocentesis of the temporomandibular joint?

Purpose: Arthrocentesis and hydraulic distention of the temporomandibular joint (TMJ) have been described as an effective modality in the treatment of patients with clinical findings consistent with the diagnosis of disc displacement without reduction. The purpose of this study was to investigate whether the magnetic resonance (MR) imaging variables of internal derangement (ID) and osteoarthrosis (OA) and the presence of capsulitis/synovitis (C/S) may be linked to changes in TMJ signs and symptoms associated with the performance of arthrocentesis and hydraulic distention. Patients and Methods: The study consisted of,27 TMJ pain patients, who were assigned a clinical unilateral TMJ diagnosis of ID type III (disc displacement without reduction). Bilateral sagittal and coronal MR images were obtained immediately preoperatively and at a 2-month follow-up to establish the presence or absence of ID and OA. TMJ pain level of function and mandibular range of motion were assessed preoperatively and compared with the respective 2-month follow-up findings. Results: The pretreatment data revealed a significant relationship between the clinical finding of TMJ pain and the MR imaging findings of ID (P < .001), ID type (P < .001), and OA (P < .05). At 2-month follow-up, clinical evaluation showed a significant reduction in TMJ pain during function (P < .001), a significant reduction in the clinical diagnoses of ID type III (P < .05), and a significant increase in mandibular range of motion (P < .05). There was no change in the prevalence rates of associated MR imaging diagnoses of TMJ ID and/or OA. Conclusion: The study findings suggest that clinical pain is related to TMJ-related MR imaging findings of ID and OA. These diagnoses proved not to be linked to changes in therapeutic outcome measures of TMJ pain and mandibular range of motion. (C) 2003 American Association of Oral and Maxillofacial Surgeons.