الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
TMD generally referred to dysfunction of TMJ and associated muscles of mastication unrelated to specific dental pain. There are many diffe~ent types of disorders that may be the source of dysfunction.
Internal derangement (ID) is one of the most common TMJ disorders which is characterized by pain, dysfunction and different joint noises as clicking, popping and crepitus. ill can be treated by non surgical and surgical methods. Non surgical methods include drug therapy, splint therapy, muscle
exercise and heat application.
The surgical techniques used in treatment of ID are divided into open surgical techniques and closed surgical techniques.the closed surgical techniques
include arthrocentesis and arthroscopy.
TMJ arthrocentesis is a procedure in which the upper joint compartment is entered by needle puncture, lavaged with a fluid as saline or ringer solution and the joint is manually manipulated. It was first described by Nitzan et al in 1991 and is usually accomplished without viewing the joint. Arthrocentesis is simple, minimally invasive, minimally expensive and without complications.
Arthrocentesis has been used in the treatment of different TMJ disorders mainly TMJ closed lock.
The current study was conducted to evaluate the efficiency of various arthrocentesis techniques for treatment ofTMJ ID. The study was designed to be a prospective randomized double blinded trial. Patient’s examination and evaluation were perfonned by utilizing the RDC/TMD in order to standardize the diagnostic criteria and the method of assessment. Twenty four patients were
enrolled in our study, randomized in to equal four group. Group A were treateq,.:
by double needles arthrocentesis, group B were treated by double canulas arthrocentesis (large pore size than needle), group C were treated by single needle arthrocentesis and group D were treated by double canulas arthrocentesis. The follow-up period was assigned to be 3-month.
The results of our study revealed significant increase in the mean mouth opening and joint sounds. non-significant difference between all groups in increasing mouth opening and alleviation of,joint sounds. Our results suggested that all techniques are equally efficient in improving mouth opening however single needle arthrocentesis is more effective in increasing mean of mouth opening at early periods of follow up.
For pain score over the follow up period, significant decrease of pain score postoperatively in double needles group than in double canulas group and statistically significant decrease of pain score postoperatively in double needles group than in single canula group and statistically significant decrease of pailY score postoperatively in double canulas group than in single canula group and no statistically significant differences between pain score in both groups double and single needle so single needle give same results as double needles.
So that; we can conclude that adequate treatment results were achieved with single and double needle arthrocentesis. single needle is more easier and avoid danger to facial nerve injury as it located anterior and medial to glenoid fossa where the 2nd needle is usually inserted. however needle pore size not affect arthrocentesis technique.