What Are the Complications of Temporomandibular Joint Arthrocentesis

Abstract

Background: Arthrocentesis is a minimally invasive procedure for treating intra-articular temporomandibular disorders. While it is considered relatively safe, like any surgical intervention, it carries potential risks. Purpose: The study purpose was to estimate the frequency of complications associated with temporomandibular joint arthrocentesis, identify risk factors, and improve preparedness for effective prevention and management strategies. Study design: In this retrospective cohort study, the investigators analyzed data from patients who underwent arthrocentesis treatment between 2015 and 2024 at Ondokuz May & imath;s University, Faculty of Dentistry. Inclusion criteria were a diagnosis of painful intra-articular temporomandibular disorders. Patients with prior temporomandibular joint surgery or systemic conditions affecting joint function were excluded. Independent variable: The independent variables included age, sex, and the presence of unilateral or bilateral arthrocentesis. Main outcome variables: The main outcome variables are major (intervention required) and minor (no intervention) complications observed during the procedure and in the early follow-up period in patients. These complications include fluid extravasation, minor bleeding, transient facial paralysis, subcutaneous emphysema, external auditory fluid, and preauricular inflammation. Covariates: Not applicable in this study. Analyses: Descriptive statistics were used to report the occurrence of complications. The X-2 test was used for categorical variables. As this is a case series, hypothesis testing is not feasible. A P value <.05 was considered statistically significant. Results: The sample comprised 210 subjects (252 joints) with a mean age of 39.16 +/- 14.59(18-82 years). Nine (4.29%) were male, and 201 (95.71%) were female. Major and minor complication rates observed in patients are 2.84 and 28.1%, respectively. The distribution of complications in the treated joints is as follows: fluid extravasation (25.71%), transient facial paralysis (14.28%), minor bleeding (1.9%), subcutaneous emphysema (0.47%), fluid outflow from the ear (0.95%), and preauricular infection (1.42%). A statistically significant relationship was found between transient facial paralysis and fluid extravasation (P < .001). Bilateral arthrocentesis was defined as a risk factor (P = .003). No significant relationship was found between the independent variables and complications. Conclusions and relevance: The findings indicate that complications during and after arthrocentesis are common but manageable. Understanding these complications and their frequencies is crucial for surgeons to know the associated risks. (c) 2025 American Association of Oral and Maxillofacial Surgeons