Arthrocentesis for Temporomandibular Disorders

Topic Overview

Arthrocentesis is done by an oral and maxillofacial surgeon, who uses needles to withdraw fluid from and/or inject fluid or medicine into a joint space. Arthrocentesis of the temporomandibular joint is used:

• To treat painful and limited jaw movement (hypomobility) or disc displacement that has caused chronic, severe pain.
• As a diagnostic tool, when there is a need to analyze joint fluid for signs of disease.

Arthrocentesis seems to work for people who have severe closed lock of the temporomandibular joint.^{footnote 1}

Arthrocentesis is done using local anesthetic, with or without a sedative. Injection of fluid into the joint can serve to:

• Wash (lavage) from the joint pain-causing chemicals created by the inflammation process.
• Reduce painful pressure or contact between the disc and bone.
• Enlarge the joint space, making it easier to manipulate the joint gently.

At the end of the procedure, corticosteroids or local anesthetic may be injected into the joint. This can be particularly helpful in cases of temporomandibular disorder related to rheumatoid arthritis.

After the procedure, nonsteroidal anti-inflammatory drugs (NSAIDs) are used to control pain. And jaw exercises are started during recovery.