Cochrane · intervention · CD004973
Arthrocentesis and lavage for treating temporomandibular joint disorders
Cochrane Database of Systematic Reviews · 2009 · Cochrane Library
Oral HealthOral and maxillofacial surgeryTemporomandibular disorders and sleep2 versionsAMSTAR 2: not assessed
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
10
current version
GRADE rated
0
No studies
5
Included studies
2
as reported
No studies 5 · 50%Ungraded 5 · 50%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | All adult patients (>18 years) with temporomandibular joint disorders, regardless of race, gender, profession or residence; diagnoses such as synovitis, disc displacement with or without reduction, degenerative pathology or osteoarthritis of the temporomandibular joint (to be subjected to subgroup analyses) | 81 patients with temporomandibular joint disorders (internal derangement: anterior disc displacement with and without reduction) across 2 RCTs; all had previously failed conservative therapy (n=81) |
| Intervention | Arthrocentesis and lavage for temporomandibular joint disorders | Arthrocentesis and lavage (n=37) |
| Comparison | Any other therapy for temporomandibular joint disorders (arthroscopy; physiotherapy; splint therapy; psychological interventions; oral medication) or no treatment/placebo | Arthroscopy (n=44) |
| Outcomes | Primary: relief of pain in the temporomandibular joint and masticatory muscles (evaluated short term <3 months and long term >=3 months); other clinical outcomes (headaches; joint sounds/crepitus; Helkimo anamnestic/dysfunction index). Secondary: patient subjective assessments (pain on face and jaw; joint clicking; dysfunction); clinical examination (maximum interincisal opening; lateral movement/protrusion; tenderness on palpation of TMJ and masticatory muscles; joint sounds); biochemical/physical indicators; quality of life; adverse events; withdrawals | Pain/VAS (n=62); Improvement in pain (n=62); Maximum incisal opening (n=81); Overall success compound score (n=19); Adverse reactions (n=62) |
| Study designs | All randomised controlled trials (RCTs), including quasi-randomised clinical trials | 2 randomised arthroscopy-controlled trials (Fridrich 1996; Goudot 2000) (n=2) |
| Timing | Short term (<3 months) and long term (>=3 months) | Follow-up 6 to 24 months (mean 12.9 months) in Fridrich 1996; 1 year in Goudot 2000 |
Search date: 2009-08. Databases: Cochrane Oral Health Group's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OVID); EMBASE (OVID); OpenSIGLE; Chinese Biomedical Literature Database (CBMdisc); Chinese Medical Library
Questions and results
Show all 2 versionsArthrocentesis and lavage vs Arthroscopy
Population: Adults with temporomandibular joint disorders (internal derangement; anterior disc displacement with or without reduction) whose symptoms and/or clinical signs had not improved after conservative therapy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse reactions 1 year | Only Goudot 2000 reported adverse reactions. Arthroscopy group: one transient frontal palsy (during 3 months); one cervico-facial oedema requiring prolonged intubation (12 hours). Arthrocentesis group: two severe… | 1 study · 62 participants | Ungraded |
Quality of life | No data about quality of life were reported by the included trials. | 0 studies | No studies |
Deviation of the mandible | To date, no randomised controlled trial in this area reported deviation of the mandible. | 0 studies | No studies |
Pain (VAS) 24 months | MD -1.00 [-2.12, 0.12] | 1 study · 62 participants | Ungraded |
Muscular tenderness | To date, no randomised controlled trial in this area reported muscular tenderness. | 0 studies | No studies |
Overall success (compound score combining pain and MIO) 6 to 24 months | RR 0.92 [0.56, 1.49] | 1 study · 19 participants | Ungraded |
Temporomandibular joint tenderness | To date, no randomised controlled trial in this area reported temporomandibular joint tenderness. | 0 studies | No studies |
Maximum bite force | To date, no randomised controlled trial in this area reported maximum bite force. | 0 studies | No studies |
Maximum incisal (mouth) opening (MIO) 6 to 24 months (Fridrich); 12 months (Goudot) | MD -5.28 [-7.10, -3.46] | 2 studies · 81 participants | Ungraded |
Improvement in pain (proportion of participants improved/healed) 1 year | RR 1.09 [0.87, 1.38] | 1 study · 62 participants | Ungraded |