An image-guided technique for puncture of the superior temporomandibular joint cavity: clinical comparison with the conventional puncture technique.

OBJECTIVE The objective of this study was to compare an image-guided puncture technique (IGPT) with conventional puncture technique (CPT) with respect to accuracy of needle entry, maximal mouth opening, and pain in pumping manipulation treatment of internal derangement of the temporomandibular joint (TMJ). STUDY DESIGN The subjects comprised 178 patients with internal derangement of the TMJ with closed lock. Treatment was provided using CPT in 102 cases and IGPT in 76 cases. Three variables, number of repunctures, maximal mouth opening distance, and pain threshold according to a visual analogue scale, were measured and compared between IGPT and CPT groups. RESULTS Access to the superior joint cavity was achieved without correcting the puncture point in 97% of patients who underwent IGPT and 82% of patients in the CPT group. Significant differences were seen in 1-week maximal mouth opening and pain threshold between IGPT and CPT groups (P < .05 each) and resetting of the puncture point was significantly less frequent using IGPT compared with CPT (P < .05). CONCLUSIONS IGPT is effective for pain mitigation and improves mouth opening during the early postoperative period after pumping manipulation treatment.