Oral and Maxillofacial Surgery

Temporomandibular Joint (TMJ) Arthroscopy and Arthrocentesis

What is Temporomandibular Joint (TMJ) Arthroscopy?

Arthroscopy is a procedure used to diagnose and treat joint problems. Surgeons may use arthroscopy when X-rays and other imaging studies have not provided enough information to make a diagnosis.

During jaw joint arthroscopy, a small incision is made and a narrow tube connected to a fiber optic video camera is inserted into the joint. The image inside the jaw joint is transmitted to a monitor, providing a detailed view without the need for major surgery. This allows the surgeon to diagnose issues such as torn or crushed cartilage and damage to the bony surfaces of the joint. Arthrocentesis, a procedure in which the joint is washed with sterile needles and solutions, can also be performed during arthroscopy to reduce pain and increase mobility.

What is Jaw Joint Arthrocentesis?

Arthrocentesis is commonly defined as the washing of the jaw joint using two sterile needles and sterile washing solutions in order to reduce pain by removing inflammatory cells from the jaw joint or to increase the mobility of the lower jaw by removing intra-articular adhesions with washing pressure. One needle is used to deliver the washing solution into the joint and the other to drain this washing solution. Lubricating solutions can also be used to facilitate joint movement after washing. Arthrocentesis is generally recommended in patients who do not respond to conservative (non-invasive) treatments. The procedure can be done during the arthroscopy application, or it can be applied alone.

What Are the Risks of Jaw Joint Arthroscopy/Arthrocentesis?

Jaw joint arthroscopy and arthrocentesis are generally considered safe and minimally invasive, with few complications. However, as with any procedure, there is a risk of damage to joint structures, tissue or nerve damage, and infection.

What should patients expect after the jaw joint arthroscopy/arthrocentesis procedure?

The arthroscopy/arthrocentesis procedure typically includes a few standard steps. The procedure is usually performed under sedation, with an intravenous catheter placed in the hand or forearm and a mild sedative administered. Local anesthetic is also used to prevent pain in the jaw joint. The patient may be semi-conscious or fully unconscious, depending on the length of the procedure and the preference of the patient and surgeon.

It is important to come with an adult companion who can drive you home and assist you on the day of the procedure. After the procedure, swelling is normal and may take 5-7 days to heal. You may also experience a temporary change in your bite due to this swelling. To minimize discomfort and speed recovery, it is important to minimize jaw movements for the first 24 hours and avoid excessive talking, yawning, chewing, or opening your mouth during this time. In the days following the procedure, you should drink plenty of fluids and eat soft, nutritious foods. You can gradually return to your normal diet as you feel comfortable. It may be more comfortable to consume soft foods for a few days after the procedure, but it is important to drink enough fluids to prevent dehydration.