• Pushkar Mehra and Varun Arya.
• Associate Professor and Chairman, Department of Oral and Maxillofacial Surgery, Boston University School of Dental Medicine; Chief, Department of Oral and Maxillofacial Surgery, Boston Medical Center, Boston, MA. Electronic address: pushkar.mehra@bmc.org.
• J. Oral Maxillofac. Surg. 2015 May 1;73(5):834-42.

PurposeAlthough arthrocentesis of the temporomandibular joint (TMJ) has been shown to be an effective, minimally invasive surgical procedure, there is a paucity of literature that has examined its effectiveness under intravenous (IV) sedation compared with general anesthesia (GA) with a secure airway.Patients And MethodsA retrospective analysis of patients with TMJ arthrocentesis was performed. Patients were divided into 2 groups based on type of anesthesia (sedation vs general) and location of surgery (office vs hospital). Visual analog scales were used to assess TMJ pain, headaches, jaw function, diet, and disability. Objective examinations were performed for maximum interincisal opening, lateral excursions, and TMJ sounds.ResultsStatistical improvements were seen for TMJ pain, headaches, dietary restrictions, jaw function, and disability. Patients reported an 80% satisfaction rate for surgery under IV sedation compared with a 95% satisfaction rate of patients who had surgery under GA.ConclusionsArthrocentesis is effective for treatment of TMJ pain and acute closed-lock conditions irrespective of Wilkes classification (grades I to III). Ninety-five percent of patients reported immediate resolution or decrease of pain within the first postoperative week. Although the procedure is effective when performed under IV sedation in an office setup, superior clinical outcomes were noticed when the procedure was performed with a secure airway under GA.Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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