Effectiveness of computer-guided versus conventional arthrocentesis in the management of temporomandibular joint disorders: a systematic review of clinical studies.

OBJECTIVE

This systematic review aimed to evaluate the clinical effectiveness and procedural accuracy of computer-guided versus conventional freehand arthrocentesis in the management of temporomandibular joint disorders.

STUDY

DESIGN

A comprehensive electronic search was conducted across 6 databases (PubMed, Embase, Scopus, Web of Science, OVID, and Cochrane Library) up to August 2025, following PRISMA guidelines (PROSPERO registration no. CRD420251123995). Eligible studies included human clinical trials comparing computer-guided or patient-specific stent-assisted arthrocentesis or intra-articular injection with conventional techniques. Risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I V2 tools.

RESULTS

Eight studies (5 randomized controlled trials and 3 prospective case series) involving 137 patients met the inclusion criteria. Computer-guided arthrocentesis demonstrated superior procedural accuracy, eliminated the need for needle relocation, and significantly reduced operative time. Guided approaches provided faster pain reduction and earlier improvement in maximum mouth opening during short-term follow-up, while long-term outcomes were comparable between guided and conventional methods. No significant complications were reported.

CONCLUSIONS

Within the limitations of current evidence, computer-guided TMJ arthrocentesis offers enhanced precision, procedural efficiency, and early clinical recovery compared with conventional freehand methods, while maintaining similar long-term outcomes.