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PURPOSE: To establish an animal model of surgically induced anterior disc displacement (ADD) without reduction in growing rabbit and semi-quantitatively assess the changes in expression of type II collagen and type X collagen with immunohistochemistry after ADD without reduction, so as to explore the effect of surgically induced ADD upon endochondral ossification of the mandibular condyle and the mechanism of mandibular asymmetry. METHODS: Surgically induced ADD without reduction was performed in 40 growing rabbits in the right side of temporomandibular joint(TMJ), while a sham operation was performed in the left side. The animals were sacrificed at 24-hour, 1-, 4-, 8-, and 12 -week after surgery. Immunohistochemical staining of type II collagen and type X collagen was performed in the condylar cartilage specimen. The data was analyzed for paired-τ test using PASW statistics 18.0 software. RESULTS: The expression of type II collagen had no significant change at 24-hour, 1-, 4-, and 8-week after surgery and increased at 12-week (P<0.05). The results showed that expression of type X collagen significantly decreased at 24-hour (P<0.01), 1-(P<0.01), and 4-week (P<0.05), but had no significant difference at 8-, and 12-week after surgery. CONCLUSIONS: The results of this study suggest that surgically induced ADD has an adverse effect on condylar endochondral ossification in early period in growing rabbits. It might be the causes of shortening of mandibular ramus and asymmetry of mandible after surgically induced ADD. Supported by National Natural Science Foundation of China (81070848 and 81200766), and Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100, 08411967400, 114119a3800). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the clinical characteristics, diagnosis and treatment of oral and maxillofacial multiple space infection with purulent pericarditis. METHODS: A total of four patients from 2005 to 2010 were included in the study. Clinical data including etiology, episode of the disease, radiology, bacteriology, treatments and outcomes were retrospectively analyzed. RESULTS: These four cases were all males, aged between 27-52 years old. They all resumed from odontogenic ildection. The interval between the diagnosis of oral and maxillofacial multiple space infection and descending necrotizing mediastinitis (DNM) was 0 to 12 days (mean 6 days), 0 to 7 days from diagnosis of DNM to purulent pericarditis (mean 2.5 days). The hospitalization time ranged from 9 to 63 days (mean 42.5 days). Four different pathogens were identified by pus and blood culture from three patients. Surgical drainage, tracheotomy and intravenous antibiotics were conducted. Three were cured while one died. CONCLUSION: With the characteristics of occult process and high mortality rate, diagnosis of DNM and purulent pericarditis should be taken into consideration when there is a complaint of chest pain or dyspnea in patients with oral and maxillofacial multiple space infection. Early detection and adequate drainage is the key to success. Bacterial culture plays a guiding role for antibiotic therapy. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of functional treatment for disk displacement with reduction (DDWR) of the temporomandibular joint (TMJ). METHODS: Fifty-seven juvenile patients (78 joints) diagnosed as DDWR underwent functional treatment. MRIs were used before and after functional treatment. The disk position was judged according to the success criteria which included all sagittal planes after treatment. Those patients, whose disk of TMJ was in normal position with remarkable condylar remolding, were evaluated to be excellent. If normal disk-condyle relationship with no remarkable condylar remolding or mild disk displacement with disk-like structure of the bilaminar zone were found, the outcome was evaluated to be good. Compared with pre-treatment, if the disk position was the same or became worse, the outcome was evaluated to be poor. Cases evaluated as "excellent" and "good", were considered as successful. RESULTS: MRI for all joints confirmed that 73.08% (57/78) were excellent; 14.10% (11/78) were good, and only 12.82% (10/78) were poor. The total effective rate was 87.18% (68/78). The effective rate for anterior repositioning splint therapy was 84.09%, 87.50% for twin-block appliance, and up to 94.44% for the Herbst functional appliance. Arthroscopic surgery or open surgery was carried out for the joints which were evaluated as poor. CONCLUSION: This study indicates that functional appliance is effective in repositioning the DDWR confirmed by MRI examination, but long-time follow-up is necessary for the evaluation of its stability. Supported by Research Fund for Young College and University Teachers from Shanghai Municipal Education Commission (jdy11027). [ABSTRACT FROM AUTHOR]

PURPOSE: To summarize the imaging features of enhanced computed tomography of oral and maxillofacial and cervical multi-space infection, and to evaluate the effect of enhanced CT for diagnosis and treatment. METHODS: Two hundred and twenty -seven consecutive cases of oral and maxillofacial and cervical multi-space infection were collected from December 2005 to December 2011, the resource of infection, CT findings, involved space, treatment outcomes and follow-up CT findings were retrospectively analyzed. RESULTS: Odontogenic and gland-borne infection was most frequent, with 167 cases and 33 cases respectively. Infection on enhanced CT showed abscess, gas bubble and cellulitis. Submandibular space was involved most frequently in 145 cases, followed by masticator space in 73 cases, pterygomandibular space in 50 cases and sublingual space in 48 cases; respiratory obstruction was found in 15 cases and descending mediastinitis was found in 11 cases; 214 cases were cured, 8 were lost to follow-up and 5 cases died. CONCLUSION: Enhanced CT should be used as preferred radiographic method of oral and maxillofacial and cervical multi-space infection. It is effective in diagnosis, guiding therapy and evaluating prognosis. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100) and Research Fund of Health Bureau of Shanghai Municipality (2012Y046). [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the relationship between temporomandibular joint (TMJ)anterior disc displacement and condyle growth by detecting the expression of Ihh and PTHrP in condylar cartilage of rabbits with TMJ anterior disc displacement. METHODS: TMJ disc displacement was surgically created in 3-month old rabbits. The animals were sacrificed at 4-week, 8-week, 12-week after surgery to investigate the histological changes and expression of Ihh and PTHrP by IHC. RESULTS: Minor disorganization was found in condylar cartilage at 4-week. At 8-week, obvious changes of cartilage was observed. At 12-week, the changes appeared more severe. Significantly increased expression of Ihh and PTHrP was detected in the deep layer of proliferating cells at 4-week. Increased expression was seen at 8-week and 12-week in the deep layer of cartilage cells. CONCLUSIONS: TMJ disc displacement led to progressive pathological changes in condylar cartilage. Ihh and PTHrP play important roles in pathological change caused by TMJ disc displacement, which suggests that TMJ disc displacement might influence endochondral ossification of the condylar cartilage through Ihh-PTHrP negative feedback loop in growth period. Supported by National Natural Science Foundation of China(81070848),Research Fund of Science and Technology Commission of Shanghai Municipality(08DZ2271100,08411967400, 114119a3800). [ABSTRACT FROM AUTHOR]

Extraction of impacted lower third molar is a common procedure. Damage of the inferior alveolar nerve (IAN) is one of the severe complications, in that the roots of the tooth are often close to the nerve canal when it is impacted at a low position. There are mainly three approaches: coronectomy, partial odontoectomy and orthodontic extraction to minimize neurological risks. A case of mesioangular impacted third molar treated with improved orthodontic extraction was reported in this paper. The orthodontic treatment consisted 2 stages, up-righting and extrusion. Supported by 2011 Medical Research Project of Health Bureau of Pudong New District of Shanghai Municipality(PW2011D-4). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the clinical features of diabetic patients with multi-space infections of the head and neck by comparing them to nondiabetic patients in order to render effective health care to this patient population. METHODS: A retrospective study was conducted on 191 patients receiving treatment for severe multi-space infections of the head and neck region. Demographics, etiology of infection, clinical parameters, laboratory values (bacteriology, blood glucose level on admission, white blood cell count on admission, and percent of neutrophil on admission) and treatment parameters (the number of incisions, complications and length of hospital stay) were collected and analyzed for clinical significance. Statistical analyses of the results between the two groups were performed using Student's t test, Chi- square test, and analysis of variance with SAS 8.0 software package. RESULTS: Odontogenic infections were the most common cause and the most commonly affected facial space was the submandibular space in both groups. The most commonly isolated organism in diabetes was Klebsiella pneumoniae, whereas Streptococcus spp in non-diabetic patients. Compared with nondiabetic patients, diabetics had more concurrently involved spaces, required more incisions for drainage, had longer hospital stays, and had more complications. Some even succumbed to death. CONCLUSION: This study has determined the differences in clinical features of patients with multi-space infections of the head and neck by comparing diabetic patients to non-diabetic patients, which may help manage or create protocols in treating the diabetic patients with these types of infections. Supported by National Natural Science Foundation of China (81100766),Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100, 10411964400), Shanghai Leading Academic Discipline Project (S30206), Program for Innovative Research Team of Shanghai Municipal Education Commission, Fund of Shanghai Municipal Health Bureau (2007008) and Medical Foundation of Shanghai Jiao Tong University (YZ1024). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate condylar remodelling after arthroscopic disc repositioning with magnetic resonance imaging (MRI) in teenage patients. METHODS: Thirty eight joints in 26 consecutive patients (aged 14-20 years) with anterior disc displacement of TMJ treated with arthroscopic disc repositioning were included from Jan 2006 to Dec 2008. Magnetic resonance imaging (MRI) was obtained before arthroscopy and after at least 6 months of treatment. Visual inspection and metric analysis were performed in the parasagittal and coronal planes shown on the MRIs. Student's t test was used to assess the changes in condylar height, width and depth after at least 6 months of treatment with SPSS 13.0 software package. RESULTS: The mean age at first visit was 17.7 years. The mean follow-up interval was 15 months. Before operation, 7 joints were in stage II of internal derangement, 26 in stage M, 2 in stage IV, and 3 in stage V . Postoperative MRI showed the disc was in normal position in all joints. The average increase of condylar depth and height in parasaggital plane after arthroscopy was 0.45mm and 0.92mm, respectively (P<0.05). No difference was found for condylar width and height in coronal plane (P>0.05). CONCLUSION: The results demonstrates that in the teenage patients with anterior disc displacement of TMJ obvious condylar remodelling can be achieved after arthroscopic disc repositioning, which might be helpful for improving facial profile. However, a well-designed prospective study is needed in the future study .Supported by National Natural Science Foundation of China (81070848), Research Fund of Science and Technology Commission of Shanghai Municipality(08DZ2271100, 08411967400,114119a3800), and Program for Innovative Research Team of Shanghai Municipal Education Commission. [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the clinical features of patients with diabetes mellitus with multi-space infections of oral and maxillofacial region by comparing them with nondiabetic patients, and to identify the factors that influenced the outcomes of infections. METHODS: A retrospective study was conducted in 117 patients diagnosed with multi-space infections of oral and maxillofacial region treated at the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital between 2007 and 2010. The study variables were demography, etiology, clinical and anatomic findings, and laboratory examinations (bacteriology, blood glucose level at admission, white blood cell count at admission, and percent of neutrophil at admission). The outcome variables were the length of hospital stay and complications. The variable for comparison was diabetic status. Statistical analysis of the results between the two groups was performed using the Student's t test, Chi-square test, variance analysis, Logistic regression analysis and linear regression analysis with SAS8.0 software package. RESULTS: Compared with nondiabetic patients, diabetic ones had more spaces involved, longer hospital stay, developed more frequent complications, and even death. The status (with or without diabetes) was associated with clinical outcomes (the length of hospital stay and complications). Only blood glucose level at admission was the major factor influencing the complications of multi-space infections in oral and maxillofacial region. CONCLUSION: This study clarify the clinical features of diabetes with multi-space infections of oral and maxillofacial region by comparing them with nondiabetic patients. Factors that influenced the outcomes of infection were indentified, which were important indicators in treating multi-space infections of oral and maxillofacial region. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100, 10411964400), Shanghai Leading Academic Discipline Project (S30206), Program for Innovative Research Team of Shanghai Municipal Education Commission, Research Fund of Shanghai Municipal Health Bureau (2007008) and Research Fund of Shanghai Jiao Tong University (YZ1024). [ABSTRACT FROM AUTHOR]

PURPOSE: The study is to quantitatively assess the changes in disc position relative to the condyle, disc length, and condylar height with magnetic resonance imaging of the temporomandivular joint disc displacement to provide useful information regarding treatment planning. METHODS: Sixty-two patients with 83 joints were involved and MRI scans of the temporomandibular joint were taken at initial and follow-up visits. The disc position relative to the condyle, disc length, and condylar height of the joints were assessed quantitatively on the MRI imagings. Student's t test was used to assess the statistical significance of the changes with SPSS13.0 software package. RESULTS: The mean age of the patients at first visit was 30.4 years. The mean follow-up interval was 10.9 months. 27 among the 39 joints with disc displacement with reduction at the initial visit changed to disc displacement without reduction after follow-up. The mean disc position relative to the condyle changed from 5.28 to 6.73 mm, whereas the mean disc length changed from 8.31 to 6.91 mm and the mean condylar height from 5.21 to 4.65 mm. Differences were all statistically significant (P<0.01). CONCLUSIONS: During the natural course of disc displacement, the disc would become more anteriorly displaced and shortened and the condylar height would decrease. However, further studies with longer follow-up and larger number of patients are necessary. Supported by National Natural Science Foundation of China (81070848)and Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100,08411967400). [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the effect of arthroscopic disc suturing for treating internal derangement of the temporomandibular joint (TMJ). METHODS: Arthroscopic disc repositioning and suturing surgery was performed on patients who visited the TMJ clinic at the Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, between May 2001 and May 2006 with stages II-V TMJ ID. The patients' ID stages were based on the criteria of Wilkes & Bronstein's classification. Consecutive MRIs were used to evaluate ID before operation and after operation for all 911 patients (1103 joints). The disc position was judged according to our success criteria which included three different sagittal planes (lateral, central and medial). Arthroscopic surgery or open surgery was carried out once more for the joints evaluated as poor. RESULTS: Postoperative consecutive MRIs for all 1103 joints confirmed that 93.56% (1032/1103) joints were excellent or good, and only 6.44% (71/1103)were poor. The average follow-up period for clinical evaluation was 15.3 months (2 to 29 months), 32.88% (48/146) was excellent, 57.53% (84/146) was good, 9.59% (14/146) was poor, the total effective rate was 90.41% (132/146). 92.47% (135/146) of the patients feels more comfortable after the operation. The effective group had an improvement in mouth opening of (14.34±5.87)mm (P<0.001). The preoperative VAS value was 29.76±23.35 (0-80), while it decreased to 3.71+7-91 (0-50) postoperatively (P<0.05). The non-effective group had no significant improvement in mouth opening (P>0.05). The preoperative VAS value of this group was 3.33±5.77 and 36.67± 30.55 postoperatively (P<0.01). There was no significant difference between MRI and clinical evaluation (P>0.05). CONCLUSION: TMJ arthroscopic suturing technique is an effective, minimally invasive surgery in repositioning the TMJ disc, but long-term follow-up is necessary for the evaluation of its stability. Supported by Shanghai Leading Academic Discipline Project (S30206), Research Fund of Shanghai Municipal Bureau of Health (2008160), Shanghai "Phosphor" Science Foundation (04QMH1415), National Natural Science Foundation of China(81070848), Natural Science Foundation of Shanghai Municipality (10ZR1418200), Ph.D. Programs of Ministry of Education of China (20090073110068), and Natural Science Foundation of Henan Province (2010C320006). [ABSTRACT FROM AUTHOR]

PURPOSE: To analyze the complications of arthroscopic surgeries in the temporomandibular joint (TMJ), and investigate the preventive and treating methods. METHODS: In this study, Consecutive 2034 patients (2431 joints) diagnosed as TMJ internal derangement (ID) were treated by arthroscopic surgeries from May 1997 to Sept. 2009 in our department. The clinical complications were analyzed for investigating its cause, prevention and control measures. RESULTS: Of all 2034 cases, the complications were shown as follows. 5 joints hemorrhage of lateral pterygoid muscle vascular, injuries of lateral pterygoid muscle nerve in 5 joints, 3 joints with broken instruments, rejection reaction in 2 joints, perforation of tympanic membrane in 2 joints. CONCLUSION: Arthroscopic surgery was a safe and effective method to treat TMJ ID, its complications were limited and acceptable, but experienced operator was required for this surgical technique. Supported by Shanghai Leading Academic Discipline Project (S30206), Natural Science Foundation of Shanghai Municipality (10ZR1418200), and Ph.D. Programs Foundation of Ministry of Education of China (20090073110068). [ABSTRACT FROM AUTHOR]

Temporomandibular joint disk displacement is common in the oral and maxillofacial region. Magnetic resonance imaging (MRI) has been widely applied to the patients with temporomandibular joint disk displacement for its direct visualization of disc. It is helpful for making the treatment planning by quantitative assessment of the disk position and length with MRI. Various MRI evaluations of disc displacement were reviewed in this report, and their advantage and disadvantage were analyzed. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce arthroscopic treatment of adhesion and evaluate the effect of arthroscopic surgery on IA of TMJ upper compartment. METHODS: 142 patients (159 joints) with intraarticular adhesion confirmed by arthroscope were treated with lysis of adhesions, intraarticular clean-up operation or capsules radiofrequency catheter ablation. 110 patients (123 joints) accompanied with disc displacement underwent disc repositioning and suturing. The follow-up index included jaw movement, VAS pain value and patients' self-evaluation. The therapeutic effect was divided into excellent, good and poor, and excellent and good patients were defined effective. Jaw movement and VAS pain value before and after operation were evaluated by paired t test using SPSS11.0 software package. RESULTS: The average follow-up period was 10.3 months (2 to 27 months). 33.80% (48/142) of all joints was excellent; 56.34% (80/142) of all joints was good, and only 9.86%(14/142) was poor. The total effective rate was 90.14% (182/142). 93.66% (133/142) of all patients felt more comfortable than that of before operation. The interincisal opening increased from preoperative (23.14±5.93)mm (range from 10 to 40mm) to postoperative (37.48±3.51)mm (range from 30 to 40mm) (P<0.01), and the pain scores reduced from 28.94±23.54(0∼80) to 4.44±10.10(0∼40) (P<0.05). CONCLUSIONS: The effect of arthroscopic surgery on TMJ IA is affirmative. Surgery can increase the patients' mouth opening, improve jaw function and reduced pain in the jaw movement. [ABSTRACT FROM AUTHOR]

PURPOSE: To introduce a method to establish a rabbit model for temporomandibular joint (TMJ) intra-capsular adhesion. METHODS: The inferior and posterior walls of the right orbit in 16 rabbits were exposed. A needle, with suture, was passed vertically through the anterior part of the disc , which was tied with an elastic rubber loop. The elastic rubber loop was stretched anteriorly from 9.5mm to 40mm and fixed in a hole drilled in the zygomatic arch. The rabbits' TMJs were examined by MRI and endoscopy to assess the TMJID and intra-capsular adhesion respectively. Then, both TMJs and the surrounding tissues were excised en bloc and placed in neutral-buffered formalin for 36 hours. The demineralized specimens were embedded in paraffin and sectioned serially for examining under light microscopy stained with hematoxylin and eosin. RESULTS: The mandible of each operated rabbit deviated to the left side with inclined attribution of incisors. The disc was displaced forward and the degree of ADD among rabbits was uniform. CONCLUSION: The present study provides an advanced method for establishing model of anterior disc displacement of the temporomandibular joint. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the influencing factors of rehabilitation of occlusion after TMJ arthroscopic disc reposition and fixation. METHODS: 243 patients with 308 joints underwent TMJ arthroscopic disc reposition and fixation. According to their malocclusion that recovered in 28 days after operation, the patients were divided into 2 groups: temporary malocclusion group and lone-standing malocclusion group. The patient's age, gender, ID stage, the history of ID were compared statistically using SAS6.12 software package. RESULTS: There was significant difference in patient's age, ID stage between the two groups. The patients in long-standing malocclusion group were older and had more advanced ID stage than the patients in temporary malocclusion group. CONCLUSION: In patients with TMJ arthroscopic disc reposition and fixation, age and ID stage are the important factors that affect the recovery of occlusion. [ABSTRACT FROM AUTHOR]

Disc repositioning is a common procedure for patients with anterior disc displacement (ADD). The purpose of this retrospective record-based study was to evaluate changes in the widths of joint spaces and condylar position changes in patients with unilateral ADD following arthroscopic disc repositioning, with the healthy sides as self-control, using magnetic resonance images (MRI).Widths of anterior, superior, and posterior joint spaces (AS, SS, and PS) were measured. The condylar position was described as anterior, centric or posterior, expressed as . Paired-t test and Chi-square test were used to analyze the data. Fifty-four records conformed to the inclusion criteria (mean age of 21.02 years). Widths of SS and PS increased significantly after surgery (P < 0.001) on the operative sides, while joint spaces of healthy sides and AS of operative sides had no significant changes. Dominant location of condyles of operative sides changed from a posterior position to an anterior position, while healthy sides were mostly centric condylar position no matter preoperatively or postoperatively. Therefore, the results of this study indicate that unilateral arthroscopic disc repositioning significantly increases the posterior and superior spaces of the affected joints, without affecting spaces of the healthy sides. [ABSTRACT FROM AUTHOR]

Objective: To explore the pathogenic organism of septic arthritis of temporomandibular joint and the culture condition of the available bacteria., Methods: Joint fluid was aspirated from 30 patients in recent 5 years. Smear and Gram stain of joint fluid were done immediately, then cultured in blood agar, bacteria-preserving culture medium, trypticase soy agar(TSA) or trypticase soy broth(TSB) under aerobic or anaerobic condition, respectively. Pathogen identification was performed with biochemical methods., Results: Microorganism were found with Gram staining in 15 out of 30 cases, but the culture of bacteria only succeeded in 5 cases. Staphylococcus saprophyticus and Staphylococcus aureus were the bacteria isolated. Bacteria was isolated in TSB mostly., Conclusions: 2 kinds of microorganism were isolated from joint fluid, and S. saprophyticus was reported for the first time. However, the positive rate was low, and the better technique for culture was expected.

Objective: To investigate the clinical characteristics and the procedure of early diagnosis of septic arthritis of temporomandibular joint (TMJ)., Methods: 30 consecutive patients with TMJ septic arthritis were included in this clinical study between 1995 and 2001. Physical examinations, joint fluid analyses, radiographic imagings and laboratory studies were performed in all cases. Sequelae were evaluated., Results: The clinical data showed 29 of the 30 patients were more than 18 years old. The infections of the TMJs were mostly through hematogenous route, and the original infectious sites could not be found in many cases. The obvious inflammatory symptoms in TMJ areas and severe morbidity were not detected in most of the cases (25/30), and a high level of polymorphonuclear cells, and some fibro-protein or cartilage fragments were seen in the synovial fluid. Microorganism were found with Gram staining in 15 of 30 cases, but the culture of bacteria only succeeded in 5 cases. S. saprophyticus and S. aureus were the common kinds of bacteria isolated. The sequelae were mild, and most of the cases had only postinfectious osteoarthritis., Conclusions: Nowadays TMJ septic arthritis has shown some new characteristics, such as occult original infectious sites, atypical and mild symptoms, and slight sequelae; Joint fluid analysis is necessary for diagnosis.

Objective: To investigate the procedure and effect on treating septic arthritis of temporomandibular joint (TMJ)., Methods: 30 patients were treated by antibiotic therapy, resting of the jaw, and local therapies. The local therapies included arthrocentesis with single needle in 20 joints, arthrocentesis with double needles in 13, arthrocentesis accompanied by submandibular drainage of the infratemporal space abscess in 1, and arthroscopy in 4. The therapeutic effects were judged by joint cavity puncture, mouth opening, jaw pain, and jaw function, and so on. Sequelae were evaluated., Results: The overall success rate of the treatment was 100% (30/30). The success rates of the 4 different management were: 14/20 in arthrocentesis with single needle, 9/13 in arthrocentesis with double needles, 1/1 in arthrocentesis combined with submandibular drainage, and 4/4 in arthroscopy, respectively. The sequelae were mild, and most of the cases had only postinfectious osteoarthritis., Conclusions: Low pressure arthrocentesis, antibiotic therapy and resting of the jaw were important components of treatment in acute septic arthritis. If infratemporal space abscess was found, submandibular drainage should be done. Arthroscopy could be recommended to those who haven't got good results by arthrocentesis or those who have already had some sequelae, such as TMJ fibrous ankylosis.