J Korean Assoc Oral Maxillofac Surg 2019; 45(1): 15~20
Evaluation of success criteria for temporomandibular joint arthrocentesis
Onur Yilmaz1, Celal Candirli1, Emre Balaban1, Mehmet Demirkol2
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University, Trabzon,
2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey
Onur Yilmaz
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University, 61080 Trabzon, Turkey
TEL: +90-462-3774811 FAX: +90-462-3253017
E-mail: onuryilmaz590@hotmail.com
ORCID: https://orcid.org/0000-0002-0460-7649
Received January 19, 2018; Revised April 18, 2018; Accepted May 6, 2018.; Published online February 28, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ).
Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ≥35 mm and visual analogue scale [VAS] score ≤3), Murakami et al.’s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ≥35 mm and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful).
Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%).
Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.
Keywords: Temporomandibular joint, Arthrocentesis, Temporomandibular joint disorders, Hyaluronic acid


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25 October 2019
Vol. 45
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