ABSTRACT
Facial and head pains are common symptoms and etiology is recognized in majority of cases, However, in some instances, the complex anatomy and emotional overlay make diagnosis difficult. The key components of any differential diagnosis are thorough knowedge of the anatomy, including the neuologic and vascular distributions, and adetailed history, Closed locking of the TMJ has been ascribed to internal derangment secondary to anteromedial disk displacement without reduction. Although the true etiologic fator of disk displacement and the process of the devolopment of internal derangment have notbeen clarified, many clinical, surgical arthrographic, and arthroscopic studies support this concept of the cause. A condition of sudden, severe, and sudden, severe, and persistant limited mouth opening, which readily responds to arthrocentesis, is postulated to a vacuum between disc and fossa in the upper compartment of temporomandibular joint. This simple treatment was found to be highiy effective in restablishing normal opening and relieving pain. Thirty-four patients(39 joints) who had sudden-onset. persistent limited mouth opening were of this study. These patients who complained TMD was treated by this arthrocenthesis limited mouth opening were subjects of this study. These patients who complained TMD was treated by this arthrocenthesis. The overall improvement, as expressed in pain and dysfunction level was 74.4%, with no recurrence of severe closed lock. So the authour thinks that this arthocenthesis is simple, effective and predictable procedure.