Arthrocentesis Versus Splint Therapy in Disc Displacement Without Reduction: A Prospective Comparative Clinical Study

Background: Disc displacement without reduction (DDWoR) is a prevalent temporomandibular disorder (TMD) marked by pain and limited mandibular motion. The comparative effectiveness of arthrocentesis and occlusal splint therapy remains debated. (1,2) Objective: To clinically assess and compare outcomes of arthrocentesis, occlusal splint therapy, and the sequential combination in managing DDWoR. Methods: Sixty patients with unilateral DDWoR, diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and magnetic resonance imaging (MRI), were randomised equally to three groups: Group I (arthrocentesis), Group II (Anterior Repositioning splint therapy) and Group III (arthrocentesis plus splint). Outcomes included maximal interincisal opening (MIO) and pain intensity (Visual Analog Scale, VAS) at baseline, 1, 3, and 6 months. Results: All groups were demographically and clinically comparable at baseline (p > 0.05). Group I achieved significant MIO and VAS improvements at 1 month (p < 0.05), with a gradual decline in MIO by 6 months. Group II achieved progressive pain relief (p < 0.05) without significant MIO gains. Group III attained and preserved significant improvements in both outcomes throughout the follow-up (p < 0.01 for MIO, p < 0.05 for VAS), with no functional relapse. Conclusion: Arthrocentesis facilitates short-term restoration of mandibular function and pain relief, whereas splint therapy predominantly addresses pain without improving mouth opening. The combination offers superior, sustained benefit and should be considered for optimal DDWoR management.