Background & Aims

Background: Temporomandibular joint ((TMJ) disorders are considered as one of the major causes of oro-cranio/facial pain. Internal derangement of the TMJ which can be further classified as anterior disc displacement with reduction (ADDWR) or without reduction (ADDWoR) is more frequently seen disorders. The clinical scenario of ID commonly consists of pain, joint sounds, limitation of mouth opening, closed lock and might be associated with osteoarthritic changes at late disease stages.

Aims: The aim of this study was to evaluate and compare the clinical efficacy of three different treatment methods used to treat unilateral TMJ-ADDWoR namely arthrocentesis followed by hyaluronic acid injection, splint therapy following arthrocentesis, and arthrocentesis only. The patients were compared in terms of pain (visual analogue scale), joint function (maximum mouth
opening and laterotrusive movements) and success rates.

Methods

One hundred and twenty six patients with unilateral TMJ-ADDwoR were assigned randomly to one of three treatment groups (42 patients in each): group 1 received arthrocentesis followed by hyaluronic acid injection, group 2 received splint therapy following arthrocentesis, and group 3 received splint arthrocentesis only. The groups were compared in terms of pain (visual analogue scale), joint function (maximum mouth opening and laterotrusive movements), and success rates. These were recorded before treatment and during follow-up after treatment (immediate, 1, 3, 6 and 12 months). The between-group and within-group differences in the data were analyzed statistically.

Results

The baseline characteristics were similar in all groups (P > 0.05). Significant improvements were
noted in all parameters compared to baseline values in all groups (all P < 0.01). The hyaluronic acid injection and splint therapy following arthrocentesis showed higher clinical efficacy compared to arthrocentesis alone in terms of pain, joint function and overall success rates at immediate, 1, 3, 6 and 12 months following the treatments (p<0.05).

Conclusions

All treatment methods improve mandibular functions and relieve pain in patients with acute ADDWoR, however arthrocentesis followed by hyaluronic acid injection or splint therapy shows greater improvements in pain, mandibular function and overall success rates having better quality of life to the patients.

References

1) Tatliu, Benliday ME, Ekren O, et al. Comparison of the effectiveness of three different treatment methods for temporomandibular joint disc displacement without reduction. Int J Oral Maxillofac Surg, 2, 64(5):603-609.

Presenting Author

Manoj Kumar Sah

Poster Authors

Manoj Kumar Sah

MD, PhD

Kathmandu Dental Hospital and Research Center

Lead Author

E-mail

Topics

  • Models: Oral/craniofacial