Office-Based Arthroscopy Versus Arthrocentesis as Treatment for Temporomandibular Joint Pain and Dysfunction: Preliminary Results of a Randomized Controlled Trial

<b>Background/Objectives</b>: Arthroscopy and arthrocentesis are routinely performed for temporomandibular joint (TMJ) disorders, but high-quality evidence regarding their efficacy relative to each other is scarce. The current study, as part of an ongoing randomized controlled trial, aimed to compare office-based arthroscopic lysis and lavage with arthrocentesis for TMJ pain and dysfunction. <b>Methods</b>: Adults (≥18 years old) referred to a tertiary care hospital with TMJ arthralgia were included. The exclusion criteria comprised systemic rheumatic disease, connective tissue disease, bony ankylosis, congenital or acquired dentofacial deformities, a history of significant jaw trauma, or systemic illnesses. The primary outcome was joint pain during mandibular movement/function (visual analog scale (VAS); 0-100 mm). The secondary outcomes included pain at rest (VAS), maximum mouth opening (mm), maximum mouth opening without increased pain (mm), protrusive and lateral movements (mm), joint noises (absent/present), and mandibular function (mandibular function impairment questionnaire score). The outcomes were registered at baseline and 3-, 6-, and 12-month follow-ups. Linear mixed models and mixed-effects logistic regressions were utilized to evaluate the effects of interventions on the repeated outcome measurements. <b>Results</b>: Twenty subjects were randomly allocated to office-based arthroscopic lysis and lavage (<i>n</i> = 10) or arthrocentesis (<i>n</i> = 10). Multivariable mixed-effects models showed significantly higher pain scores during mandibular movement/function in the arthrocentesis group compared with arthroscopy (22.42 mm (95% CI: 5.28 to 39.57); <i>p</i> = 0.011). The secondary outcomes were not significantly different between the interventions. <b>Conclusions</b>: The preliminary results show the superiority of office-based arthroscopy over arthrocentesis in reducing pain during mandibular movement/function over a follow-up period of 1 year while showing no differences between interventions regarding other study outcomes.