Optimising needle depth in temporomandibular joint arthrocentesis: a magnetic resonance-based study for safety and efficacy

The aim of this paper was to determine the optimal needle depth for temporomandibular joint (TMJ) arthrocentesis using magnetic resonance imaging (MRI), with the aim of improving procedural safety and efficacy in clinical practice. A retrospective analysis of 264 TMJ MRIs from 132 patients at Istanbul Medipol Mega University Hospital was conducted. T2-weighted MRI sequences were utilised to measure distances from skin to joint capsules at varying needle entry points, applying the double puncture technique. The study adhered to ethical standards with appropriate approvals. The analysis revealed significant gender-related variations in needle depths (females showing shorter distances than males, p < 0.05). No significant gender differences were found in condylar angles. An inverse correlation between age and condylar angle suggested age-related anatomical changes. Crucially, a 20 mm needle depth was identified as safer and more effective than the previously recommended 25 mm. This study underscores the necessity of revising needle depth to 20 mm in TMJ arthrocentesis. These findings hold significant implications for improving procedural safety and catering to demographic variations.