What Are the Complications of Temporomandibular Joint Arthrocentesis?

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 Mayıs 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 χ 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.