Objectives <p>Arthrocentesis is a commonly employed surgical option for managing temporomandibular joint (TMJ) disorders. Nonetheless, surgeons frequently encounter challenges when trying to locate the supra-articular space, leading to increased surgical trauma. This study aimed to present a device for guided arthrocentesis that relies on cone-beam CT scan, virtual planning, and 3D printing technology.</p> Methods <p>A cone-beam CT scan of a 33-year-old man experiencing pain and clicking in his TMJ was imported into the Implant Studio software (3Shape, Copenhagen, Denmark). Two virtual dental implants, with the same width and length of the needles used on arthrocentesis, were virtually positioned on the supra-articular space considering straight access without impediments and preventing any touch on the mandible head. The device was designed using the dental implant surgical guide tool, ensuring ample surface for stability, and "safety stops" were added to control needle depth. It was then 3D printed in resin.</p> Results <p>A tridimensional biomodel of the ear, temporal bone, and mandible head was also printed to check the device adaptation. Once the guide was in the right place, two needles were inserted to check their position and depth. A safe distance from the condyle was verified through a cone-beam CT scan of the biomodel.</p> Conclusion <p>Based on this pre-clinical preliminary experiment, we conclude that the arthroguide may be a viable tool for TMJ arthrocentesis. Unlike previous devices, our guide integrates measurement by virtual planning and design before 3D printing, ensuring precise needle positioning.</p>