Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments
Abstract Minimally invasive therapeutic procedures have been applied for the management of degenerative joint disease in the temporomandibular joint (TMJ). This study describes a modified technique of arthrocentesis with concentric needle and cannula in the TMJ associated with viscosupplementation a...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-06715-1 |
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| author | Eduardo Januzzi Patrícia Pauletto Thays Crossara Abrahão Cunha Graziella Silva Murilo Kazuo Iwassake Miguel de Pedro Juan Fernandez Alexsander Ribeiro Pedrosa Beatriz Dulcinéia Mendes de Souza Adriana Soares Bicalho Duarte Marcella Rezende Serpa Zanini Isabela Hübner Susana Perdigoto Pedro Gonçalves de Oliveira Antônio Luís Neto Custódio Mauricio Augusto Aquino de Castro |
| author_facet | Eduardo Januzzi Patrícia Pauletto Thays Crossara Abrahão Cunha Graziella Silva Murilo Kazuo Iwassake Miguel de Pedro Juan Fernandez Alexsander Ribeiro Pedrosa Beatriz Dulcinéia Mendes de Souza Adriana Soares Bicalho Duarte Marcella Rezende Serpa Zanini Isabela Hübner Susana Perdigoto Pedro Gonçalves de Oliveira Antônio Luís Neto Custódio Mauricio Augusto Aquino de Castro |
| author_sort | Eduardo Januzzi |
| collection | DOAJ |
| description | Abstract Minimally invasive therapeutic procedures have been applied for the management of degenerative joint disease in the temporomandibular joint (TMJ). This study describes a modified technique of arthrocentesis with concentric needle and cannula in the TMJ associated with viscosupplementation and/or orthobiologics. Its effects were evaluated based on clinical outcomes related to pain, mouth opening, and joint sound, along with longitudinal tomographic evaluation based on the Wilkes classification. A prospective study was conducted with 22 patients (44 TMJs) undergoing arthrocentesis complemented by ultrasonography. The technique allowed effective lavage followed by infiltration into both the upper and lower compartments, using therapeutic agents selected based on the stage of articular temporomandibular disorder (TMD) according to the Wilkes classification. Clinical and tomographic assessments were performed before and after treatment, with follow-up ranging from 12 to 14 months. Significant improvements in pain outcomes (p < 0.001) and mouth opening amplitude (p < 0.001) were observed in all patients. There were no significant changes in joint sound post-treatment. The Wilkes classification revealed a reduction in degenerative stages in both the right (p = 0.003) and the left (p = 0.007) TMJs. The modified arthrocentesis technique combined with viscosupplementation and/or orthobiologics (platelet-rich fibrin) has been shown to be effective in reducing pain and improving TMJ function, suggesting a minimally invasive and safe approach for managing advanced articular TMDs. Future studies are recommended to confirm its applicability in different populations and in individuals with vary stages of TMD. |
| format | Article |
| id | doaj-art-9d140f8a92a140d98e9b69e5ce74bcf8 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-9d140f8a92a140d98e9b69e5ce74bcf82025-08-20T03:43:02ZengNature PortfolioScientific Reports2045-23222025-07-0115111910.1038/s41598-025-06715-1Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartmentsEduardo Januzzi0Patrícia Pauletto1Thays Crossara Abrahão Cunha2Graziella Silva3Murilo Kazuo Iwassake4Miguel de Pedro5Juan Fernandez6Alexsander Ribeiro Pedrosa7Beatriz Dulcinéia Mendes de Souza8Adriana Soares Bicalho Duarte9Marcella Rezende Serpa Zanini10Isabela Hübner11Susana Perdigoto12Pedro Gonçalves de Oliveira13Antônio Luís Neto Custódio14Mauricio Augusto Aquino de Castro15Orofacial Pain Center of the Mater Dei Hospital, Postgraduate Program in Orofacial Pain and Temporomandibular Disorders, Neon CursosUniversidad de Las AméricasFederal University of UberlândiaEuropean Centre of Dentistry SpecialityFederal University of Santa CatarinaOrofacial Pain, Oral Pathology and Dental Sleep Medicine Research Group, Department of Postgraduate Clinical Dentistry, European University of MadridServiço de Cirurgia Oral y Maxilofacial Hospital Universitário Sanitas La ZarzuelaOrofacial Pain Center of the Mater Dei HospitalFederal University of Santa CatarinaFaculty of Sete LagoasFaculty of Sete LagoasOrofacial Pain Center of the Mater Dei Hospital, Postgraduate Program in Orofacial Pain and Temporomandibular Disorders, Neon CursosResearch Group, European University of MadridInstituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São PauloBiological Sciences Institute of the Federal University of Minas GeraisDepartment of Dental Clinics, Oral Pathology and Oral Surgery of the Faculty of Dentistry of the Federal University of Minas GeraisAbstract Minimally invasive therapeutic procedures have been applied for the management of degenerative joint disease in the temporomandibular joint (TMJ). This study describes a modified technique of arthrocentesis with concentric needle and cannula in the TMJ associated with viscosupplementation and/or orthobiologics. Its effects were evaluated based on clinical outcomes related to pain, mouth opening, and joint sound, along with longitudinal tomographic evaluation based on the Wilkes classification. A prospective study was conducted with 22 patients (44 TMJs) undergoing arthrocentesis complemented by ultrasonography. The technique allowed effective lavage followed by infiltration into both the upper and lower compartments, using therapeutic agents selected based on the stage of articular temporomandibular disorder (TMD) according to the Wilkes classification. Clinical and tomographic assessments were performed before and after treatment, with follow-up ranging from 12 to 14 months. Significant improvements in pain outcomes (p < 0.001) and mouth opening amplitude (p < 0.001) were observed in all patients. There were no significant changes in joint sound post-treatment. The Wilkes classification revealed a reduction in degenerative stages in both the right (p = 0.003) and the left (p = 0.007) TMJs. The modified arthrocentesis technique combined with viscosupplementation and/or orthobiologics (platelet-rich fibrin) has been shown to be effective in reducing pain and improving TMJ function, suggesting a minimally invasive and safe approach for managing advanced articular TMDs. Future studies are recommended to confirm its applicability in different populations and in individuals with vary stages of TMD.https://doi.org/10.1038/s41598-025-06715-1ArthrocentesisTemporomandibular jointTemporomandibular disorder |
| spellingShingle | Eduardo Januzzi Patrícia Pauletto Thays Crossara Abrahão Cunha Graziella Silva Murilo Kazuo Iwassake Miguel de Pedro Juan Fernandez Alexsander Ribeiro Pedrosa Beatriz Dulcinéia Mendes de Souza Adriana Soares Bicalho Duarte Marcella Rezende Serpa Zanini Isabela Hübner Susana Perdigoto Pedro Gonçalves de Oliveira Antônio Luís Neto Custódio Mauricio Augusto Aquino de Castro Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments Scientific Reports Arthrocentesis Temporomandibular joint Temporomandibular disorder |
| title | Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments |
| title_full | Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments |
| title_fullStr | Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments |
| title_full_unstemmed | Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments |
| title_short | Outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both TMJ compartments |
| title_sort | outcomes of modified arthrocentesis using concentric needle and cannula technique with sequential viscosupplementation and orthobiologics in both tmj compartments |
| topic | Arthrocentesis Temporomandibular joint Temporomandibular disorder |
| url | https://doi.org/10.1038/s41598-025-06715-1 |
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