LAUSR

OBJECTIVE To compare intraoperative and postoperative outcomes between the single puncture and the standard double puncture techniques of arthrocentesis. METHODS PubMed, Embase, ScienceDirect, and CENTRAL databases were searched from inception up to 31st August 2020. Randomized controlled trials (RCTs), prospective and retrospective studies conducted on patients with temporomandibular joint disorders comparing any type of single puncture arthrocentesis with standard double puncture arthrocentesis and reporting intra-operative/post-operative outcomes were included. Assessment of the risk of bias was done with the Cochrane Collaboration risk assessment tool. RESULTS Thirteen studies were included (12 were RCTs). Analysis of a limited number of studies indicated no difference in pain or maximal mouth opening (MMO) between the single puncture type 1 or type 2 and the double puncture technique at various follow-up intervals. Pooled analysis (four studies) demonstrated that the single puncture type 2 technique requires significantly less operating time as compared to the double puncture method. No such difference was noted between single puncture type 1 vs double puncture techniques. Analysis of two studies indicated significantly reduced intra-operative needle relocations with the single puncture techniques. Studies were not of high quality with concerns of bias in randomization, allocation concealment, and blinding. CONCLUSIONS Limited data indicates no difference in pain or MMO with single or double puncture techniques of arthrocentesis. Amongst the three techniques, the single puncture type 2 technique has the advantages of significantly lower operating time and reduced intra-operative needle relocations and it may be the preferred method of TMJ arthrocentesis in clinical practice.