Clinical evaluation of different arthrocentesis techniques in the treatment of temporomandibular joint disorders

Temporomandibular joint arthrocentesis has undergone several technical modifications aimed at simplifying joint access and improving procedural efficiency. However, some single-puncture techniques require specially manufactured cannula systems that may not be readily available in all clinical settings. This study compared the intraoperative performance and clinical outcomes of a manually assembled, unsoldered Y-shaped double-puncture arthrocentesis technique using standard needles with those of single-puncture arthrocentesis using a prefabricated soldered Y-shaped cannula in patients with Wilkes stage II–III temporomandibular disorders. This retrospective study included 50 patients with unilateral Wilkes stage II–III temporomandibular disorders who had not responded to at least six months of conservative treatment. Group 1 ( n = 25) underwent double-puncture arthrocentesis using two standard 22-gauge needles manually bent and assembled into an unsoldered Y-shaped configuration, whereas Group 2 ( n = 25) underwent single-puncture arthrocentesis using a prefabricated soldered Y-shaped cannula. Intraoperative parameters and clinical outcomes were evaluated preoperatively and at 1 and 6 months postoperatively. Cross-sectional intergroup comparisons at each evaluation period were performed using the Mann–Whitney U test, Chi-square test, or Fisher’s exact test, as appropriate. Both techniques resulted in significant postoperative improvements in functional and clinical outcomes. Single-puncture arthrocentesis with the prefabricated Y-shaped cannula required significantly fewer needle insertion attemps than the manually assembled technique ( p = 0.049), whereas procedure duration, intraoperative complications, and treatment tolerance did not differ significantly between groups. No significant between-group differences in functional movements, pain intensity, or self-reported masticatory function were observed preoperatively or at 1 month. At 6 months, protrusive movement was significantly greater in Group 1 ( p = 0.035), whereas self-reported masticatory function was significantly higher in Group 2 ( p = 0.015). Other evaluated clinical symptoms showed no significant between-group differences during follow-up. Within the limitations of this retrospective study, no statistically significant between-group differences were detected for most assessed clinical outcomes. Double-puncture arthrocentesis using a manually assembled unsoldered Y-shaped configuration required more needle insertion attempts, while isolated differences at 6 months favored DPA for protrusive movement and SPA Type II for self-reported masticatory function. The manually assembled configuration may represent a practical and accessible option for temporomandibular joint arthrocentesis when prefabricated cannula systems are unavailable. These findings should not be interpreted as demonstrating equivalence or superiority of either technique. ClinicalTrials.gov, NCT07327099; retrospectively registered on (24.12.2025).