Abstract: PURPOSE: To evaluate the effectiveness of arthrocentesis vs disc anchorage for treatment of temporomandibular joint internal derangement of Wilkes Ⅲ-Ⅴ stages. METHODS: From January 2011 to January 2014,286 patients who accepted arthrocentesis and disc anchorage were included in this study and were divided into 2 groups according to the treatment modality: 164 patients in group A ( arthrocentesis),122 patients in group B(disc anchorage). MRI and clinical examination including crepitus, opening degree between incisors, VAS and headache were taken pretreatment and 6 months postoperatively and the follow-up time was 6 to 42 months. SPSS 13.0 software package was used for statistical analysis. RESULTS: There were significant differences in crepitus, opening degree, headache and VAS between group A and group B(χ²₁=14.33and χ²₂=57.24,P<0.05; t₁=30.30, t₂=21.37, P<0.05). The follow-up MRI showed no disc reduction in group A, except 5.5% of the patients experienced adaptive remodeling (disc-like changes) in bilaminar zone of the disc, while normal disc-condyle relationship was found in all patients of group B. CONCLUSIONS: As the symptoms disappeared, adaptive remodeling(disc-like changes) in bilaminar zone of the disc could occur but only in 5.5% of the patients after arthrocentesis. Combined clinical effect and MRI findings we conclude that disc anchorage is superior to arthrocentesis for treatment of TMJID of Wilkes Ⅲ-Ⅴ stages .

Key words: Temporomandibular joint, Arthrocentesis, Disc anchorage