Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
September 11, 2026 · via Europe PMC
Trigeminocardiac Reflex May Occur During Temporomandibular Joint Arthrocentesis.
Çoban E, Bilgin M, Erkan GN, Altay B.
AI summary — for doctors, generated from the abstract only
The trigeminocardiac reflex occurred in nearly half of TMJ arthrocentesis procedures, and longer procedure duration was associated with its occurrence.
What was studied
A prospective cohort of 35 patients undergoing 41 TMJ arthrocentesis procedures, assessing TCR (10% or greater drop in pulse or MAP) and associated factors.
Key findings
- TCR occurred in 45.7% of patients and 46.3% of procedures
- Trait anxiety was higher in those with TCR on univariate analysis
- Procedure duration was independently associated with TCR (AOR 1.41); anxiety measures were not
Clinical relevance
Suggests hemodynamic monitoring during arthrocentesis may be warranted, though the small sample limits precision.
Who should care
Limitations
Small single-centre sample; clinical consequences of TCR episodes are not described.
Heart rate or blood pressure drops from the trigeminocardiac reflex were common during TMJ arthrocentesis.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The trigeminocardiac reflex (TCR) has been described during various oral and maxillofacial procedures involving trigeminal nerve stimulation. However, TCR during temporomandibular joint (TMJ) arthrocentesis remains insufficiently investigated.
Purpose
The purpose of this study was to estimate the frequency of TCR during TMJ arthrocentesis and to identify factors associated with TCR.
Study design, setting, and sample
A prospective cohort study included consecutive patients presenting to the Department of Oral and Maxillofacial Surgery, Kırıkkale University, between January and May 2026 with TMJ intra-articular pain and dysfunction requiring TMJ arthrocentesis. Subjects with systemic disease, cardiovascular rhythm disorders, psychiatric diagnoses, or inability to complete anxiety scales were excluded.
Predictor variables
Predictor variables included demographic variables (age, sex, education level, and employment status), anxiety-related variables (state and trait anxiety), and operative variables (procedure duration).
Covariates
Not applicable.
Main outcome variables
The primary outcome was a TCR-related hemodynamic response, defined as a ≥10% decrease from baseline in pulse rate and/or mean arterial pressure.
Statistical analysis
Continuous variables were compared using the Welch t-test or Mann-Whitney U test and categorical variables using χ2 tests. Linear mixed-effects models accounted for clustered observations, and multivariable logistic regression assessed factors associated with TCR. A P value < .05 was considered statistically significant.
Results
The sample included 35 subjects undergoing 41 TMJ arthrocentesis procedures. The mean age was 38.3 years (SD, 13.2), and 22 subjects (62.9%) were female. TCR occurred in 16 of 35 subjects (45.7%) and in 19 of 41 arthrocentesis procedures (46.3%). Trait anxiety scores were higher in subjects with TCR than in those without TCR (median interquartile range, 43.5 [5.8] vs 37.0 [13.0]; P = .023), whereas state anxiety scores were similar between groups (mean ± SD, 38.9 ± 10.5 vs 38.6 ± 8.7; P = .9). In multivariable logistic regression analysis, procedure duration was associated with TCR occurrence (adjusted odds ratio = 1.41, P = .006), whereas anxiety measures were not.
Conclusion
TCR may occur during TMJ arthrocentesis at different procedural stages, and longer procedure duration was associated with TCR occurrence, whereas anxiety measures were not. Hemodynamic monitoring may be required throughout TMJ arthrocentesis, particularly during prolonged procedures.
DOI
10.1016/j.joms.2026.08.026
PMID
42790523
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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