European Journal of General Dentistry, 2026 (Scopus)
Temporomandibular joint disorders (TMDs) affect a substantial proportion of the population and represent the second most common musculoskeletal complaint after chronic low back pain. Arthrocentesis has emerged as an effective, minimally invasive, and cost-efficient treatment option for patients who do not respond adequately to conservative therapies such as nonsteroidal anti-inflammatory drugs, physiotherapy, and occlusal splints. Since its first description by Nitzan in 1991, both the technical aspects of arthrocentesis and the range of intra-articular agents used in conjunction with lavage have evolved considerably. Recent developments include single-needle and modified techniques, image-guided and navigation-assisted approaches, and the use of orthobiologic agents such as platelet concentrates and bone marrow-derived products. This narrative review summarizes contemporary diagnostic imaging and functional assessment methods, modern conservative treatment modalities, current arthrocentesis techniques, and up-to-date evidence on intra-articular pharmacologic and biologic agents. In addition, a pragmatic clinical decision-making framework is outlined to situate arthrocentesis within a stepwise management algorithm for TMDs. Overall, current data support arthrocentesis as a safe and effective option in selected patients; however, heterogeneity in techniques and injection protocols underscores the need for well-designed randomized controlled trials to establish standardized, patient-specific treatment pathways.