TMJ Arthrocentesis

Arthrocentesis is commonly defined as the lavage or wash out of the TMJ without viewing the joint space using small sterile needles and saline or lactated Ringers solution.  This procedure if performed by a trained Oral and Maxillofacial Surgeon is predictable, non-invasive and effective in pain relief by reducing joint inflammation and to increase jaw mobility by removing joint adhesions (scar tissue) and small bone spurs.  

How is TMJ Arthrocentesis performed?

TMJ arthrocentesis is an in-office procedure performed under local anesthesia with IV sedation or general anesthesia. Dr. Bolourian will discuss in detail the mode of anesthesia that best fits your condition and situation. Under sterile conditions, local anesthetic (numbing medicine) is delivered to the affected temporomandibular joint (TMJ). A small, TMJ specific designed trocar is then delivered into the TMJ (Superior Joint Space). A sterile solution (Lactated Ringers or Normal Saline) is then delivered to wash out the joint and remove and dilute inflammation within the joint. Small bone spurs which are formed in response to inflammation will also be removed through this non-invasive procedure. Depending on your condition, Dr. Bolourian may offer a series of autogenous platelet rich plasma (your blood products) injections within the joints. Recent studies have shown platelet rich plasma (PRP) help release growth factors which helps promote bone healing and bone quality in the joint. PRP has also shown to significantly reduce pain within the TMJ in long terms.

Are you a candidate for TMJ arthrocentesis? 

Typically patients with chronic TMJ pain associated with osteoarthritis, acute closed lock or inability to open their mouth and TMJ click associated with pain are good candidates for TMJ arthrocentesis. After obtaining a thorough history and physical examination, typically a TMJ specific CT scan is performed right here at our office. A TMJ scan enables us to see close up inside the joint and diagnose many conditions naked eyes are not able to tell us. If necessary, Dr. Bolourian may recommend an MRI to diagnose problems within the TMJ disk. The main objective of arthrocentesis is to wash out inflammatory mediators, release the disc, break adhesions, eliminate pain and improve joint mobility. The decision to perform arthrocentesis versus arthroscopy depends on the chronicity, type of disease condition within the joint and other factors which will be discussed with you at your consultation with Dr. Bolourian.

How is your recovery after TMJ arthrocentesis?

Arthrocentesis of the temporomandibular joint is a minimally invasive treatment method at the boundary between conservative and surgical therapy. It is usually performed on an outpatient basis under IV sedation and local anesthesia.  It is a method with a minimum number of complications. You should expect to get back to normal activities 24 hours after the procedure. So the procedure does not have a significant downtime and recovery.

When should you expect improvements after TMJ Arthrocentesis?

Depending on the problem associated with your TMJ, improvement after arthrocentesis procedure should be expected within few days. During recovery and rehabilitation, anti-inflammatories and the use of TMJ splints will help relieve the symptoms. In closed lock cases (lockjaw), we often see improvement immediately after the procedure. 

Will you be able to chew normal food after TMJ Arthrocentesis?

Dr. Bolourian strongly recommends a soft diet after any TMJ treatments and arthrocentesis is no exception. Maintaining a soft diet regimen is very crucial in healing injured temporomandibular joint. At your consultation we will give you extensive nutritional guidance about the type of food you should consume that is heart and TMJ healthy.

Do I need additional treatments after TMJ Arthrocentesis?

Depending on your TMJ condition, arthrocentesis can be a one time and successful treatment for many patients. There are specific conditions which arthrocentesis may not produce adequate response. Advanced degenerative joint diseases and few other conditions may require further surgical interventions, such as arthroscopy, and open joint surgery.