METHODS: A bibliographic research has been carried out in the PubMed database using following keywords arthrocentesis, temporomandibular joint. The 27 articles published between 1991 and 2016, indicating patient\'s inclusion criterions and objectively evaluating the clinical results (mouth opening, intra-articular noises, pain) were selected. Pharmacological agents were noticed when used.
RESULTS: 1. All authors concluded to the efficacy of intra-articular washout. No prognostic factor for arthrocentesis efficacy could be identified. 2. Main pharmacological agents used were steroids, hyaluronic acid, morphine-based drugs and platelet rich plasma. Superiority of ith-injection protocols failed to win unanimous support. All authors who compared with- and without-injection protocols concluded to the superiority of with-injection protocols, whatever the agent.
CONCLUSIONS: Numerous studies have proven the efficacy of intra-articular washout for the treatment of TMDs resistant to noninvasive treatments. The advantage of any kind of pharmacological agent is not clear. Mechanisms of action are not all elucidated. No pharmacological agent showed any superiority over another. Study methodologies are often defective: imprecise inclusion criterions, short follow-up, confounding variables not taken into account, few comparison between pharmacological agents.