Temporomandibular joint arthrocentesis and lavage

Abstract

DATA SOURCES: The Cochrane Oral Health Group's Trials Register, Cochrane CENTRAL (Cochrane Library), Medline and Embase were used to identify likely studies. OpenSIGLE,(*) CBMdisc (the Chinese Biomedical Literature Database) and the Chinese Medical Library were also searched. All the Chinese professional journals in the oral health field were searched by hand and conference proceedings were consulted. There was no language restriction.STUDY SELECTION: Randomised controlled trials (RCT) and quasi-RCT that aimed to test the therapeutic effects of arthrocentesis and lavage on temporomandibular joint (TMJ) disorders were included.ATA EXTRACTION AND SYNTHESIS: Two review authors independently extracted data, and three review authors independently assessed the risk of bias of included trials. The first authors of the selected articles were contacted for additional information. Results: Two trials were included in the review, one of which was judged to have a high risk of bias and one to be unclear in its risk of bias. The two trials, which included 81 individuals who had TMJ disorders, compared arthrocentesis with arthroscopy. No statistically significant difference was found between the interventions in terms of pain. A statistically significant difference was found in favour of arthroscopy in maximum incisal opening (weighted mean difference of -5.28; 95% confidence interval, -7.10 to -3.46). Mild and transient adverse reactions, such as discomfort or pain at the injection site, were reported in both groups. No data about quality of life were reported.CONCLUSIONS: There is insufficient, consistent evidence to either support or refute the use of arthrocentesis and lavage for treating patients with TMJ disorders. Further high-quality RCT of arthrocentesis need to be conducted before firm conclusions can be drawn with regard to its effectiveness.