Skip to main content
Top
Published in: Journal of Maxillofacial and Oral Surgery 1/2024

07-10-2022 | Craniomandibular Dysfunction and Stress | Original Article

Use of Sodium Hyaluronate and Triamcinolone Acetonide Following Arthrocentesis in Treatment of Internal Derangement of Temporomandibular Joint: A Prospective Randomized Comparative Study

Authors: Ravina Dharamsi, Kumar Nilesh, C. D. Mouneshkumar, Pankaj Patil

Published in: Journal of Maxillofacial and Oral Surgery | Issue 1/2024

Login to get access

Abstract

Background

Internal derangement (ID) of temporomandibular joint (TMJ) is a common temporomandibular disorder (TMD) which causes hypomobility of the joint. Minimally invasive treatment modality like arthrocentesis is used as first-line of management having low morbidity and high efficacy. This prospective randomized comparative study was carried to compare the efficacy of intra-articular injection with sodium hyaluronate (SH) and triamcinolone acetonide (TA) after arthrocentesis in ID of TMJ.

Materials and Methods

A total 40 patients diagnosed with ID (stage 1–4) were included in the study and randomly divided in two groups. Twenty patients (group A) received intra-articular injection of SH while 20 patients (group B) received intra-articular injection of TA, after arthrocentesis. The clinical parameters of pain (VAS), Maximum mouth opening (MMO) (mm) and clicking sound (present/absent) were evaluated pre-operatively and at seventh day, 1 month and 3 months post-operatively.

Results

There was statistically significant improvement in pain scores in both the groups at all time intervals with SH being superior (p value 0.0086). All the patients showed improved mouth opening at all time intervals, TA being superior but statistically insignificant (p value 0.59). There was reduction in the clicking sound in both the groups which was statistically insignificant at all time intervals.

Conclusions

Arthrocentesis followed by intra-articular injection with SH is superior to TA in terms of pain reduction, while TA showed superiority in terms of improved mouth opening.
Literature
1.
go back to reference Tvrdy P, Heinz P, Pink R (2013) Arthrocentesis of the temporomandibular joint: a review. Biomedical Papers of the Faculty of Medicine of Palacky University, Olomouc Czech Republic Tvrdy P, Heinz P, Pink R (2013) Arthrocentesis of the temporomandibular joint: a review. Biomedical Papers of the Faculty of Medicine of Palacky University, Olomouc Czech Republic
3.
go back to reference Miloro M, Ghali GE, Larsen PE, Waite PE (2004) Peterson’s principles of oral and maxillofacial surgery. In: Anatomy and pathophysiology of the temporomandibular joint, vol 2, 3 edn, p 1041 Miloro M, Ghali GE, Larsen PE, Waite PE (2004) Peterson’s principles of oral and maxillofacial surgery. In: Anatomy and pathophysiology of the temporomandibular joint, vol 2, 3 edn, p 1041
4.
go back to reference Lee S, Yoon HJ (2009) MRI findings of patients with temporomandibular joint internal derangement: before and after performance of arthrocentesis and stabilization splint. J Oral Maxillofac Surg 67:314–317CrossRefPubMed Lee S, Yoon HJ (2009) MRI findings of patients with temporomandibular joint internal derangement: before and after performance of arthrocentesis and stabilization splint. J Oral Maxillofac Surg 67:314–317CrossRefPubMed
5.
go back to reference Wilkes CH (1989) Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg 115:469–477CrossRefPubMed Wilkes CH (1989) Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg 115:469–477CrossRefPubMed
6.
go back to reference Dimitroulis G, Dolwick MF, Martinez A (1995) Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg 33(1):23–27CrossRefPubMed Dimitroulis G, Dolwick MF, Martinez A (1995) Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg 33(1):23–27CrossRefPubMed
7.
go back to reference Nitzan DW, Dolwick MF, Martinez GA (1991) Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Maxillofac Oral Surg 49(11):1163–1167CrossRef Nitzan DW, Dolwick MF, Martinez GA (1991) Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Maxillofac Oral Surg 49(11):1163–1167CrossRef
8.
go back to reference Patel P, Idrees F, Newaskar V, Agrawal D (2016) Sodium hyaluronate: an effective adjunct in temporomandibular joint arthrocentesis. J Oral Maxillofac Surg 20(4):405–410CrossRef Patel P, Idrees F, Newaskar V, Agrawal D (2016) Sodium hyaluronate: an effective adjunct in temporomandibular joint arthrocentesis. J Oral Maxillofac Surg 20(4):405–410CrossRef
9.
go back to reference Giraddi GB, Siddaraju A et al (2012) Comparison between betamethasone and sodium hyaluronate combination with betamethasone alone after arthrocentesis in the treatment of internal derangement of temporomandibular joint-using single puncture technique: a preliminary study. J Maxillofac Oral Surg 14(2):403–409CrossRef Giraddi GB, Siddaraju A et al (2012) Comparison between betamethasone and sodium hyaluronate combination with betamethasone alone after arthrocentesis in the treatment of internal derangement of temporomandibular joint-using single puncture technique: a preliminary study. J Maxillofac Oral Surg 14(2):403–409CrossRef
10.
go back to reference Huddleston Slater JJR, Vos LM et al (2012) Randomized trial on the effectiveness of dexamethasone in temporomandibular joint arthrocentesis. J Dent Res 91(2):173–178CrossRefPubMed Huddleston Slater JJR, Vos LM et al (2012) Randomized trial on the effectiveness of dexamethasone in temporomandibular joint arthrocentesis. J Dent Res 91(2):173–178CrossRefPubMed
11.
go back to reference Samiee A, Sabzerou D et al (2011) Temporomandibular joint injection with corticosteroid and local anesthetic for limited mouth opening. J Oral Sci 53(3):321–325CrossRefPubMed Samiee A, Sabzerou D et al (2011) Temporomandibular joint injection with corticosteroid and local anesthetic for limited mouth opening. J Oral Sci 53(3):321–325CrossRefPubMed
12.
go back to reference Tabrizi R et al (2014) Outcomes of arthrocentesis for the treatment of ID pain: with or without corticosteroids? J Craniofac Surg 25(6):571–575CrossRef Tabrizi R et al (2014) Outcomes of arthrocentesis for the treatment of ID pain: with or without corticosteroids? J Craniofac Surg 25(6):571–575CrossRef
13.
go back to reference Vrioni J, Isufi R et al (2016) The use of arthrocentesis in patients with temporomandibular joint dysfunction. Anglisticum J 5(7):58–60 Vrioni J, Isufi R et al (2016) The use of arthrocentesis in patients with temporomandibular joint dysfunction. Anglisticum J 5(7):58–60
14.
go back to reference Thomas H, Neelakantan RS, Thomas TK (2012) Role of arthrocentesis in the management of acute closed lock of temporomandibular joint: a pilot study. J Maxillofac Oral Surg 11(4):390–393CrossRefPubMedPubMedCentral Thomas H, Neelakantan RS, Thomas TK (2012) Role of arthrocentesis in the management of acute closed lock of temporomandibular joint: a pilot study. J Maxillofac Oral Surg 11(4):390–393CrossRefPubMedPubMedCentral
15.
go back to reference Kopp S, Carlsson GE et al (1987) Long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis. J Maxillofac Oral Surg 45(11):929–935CrossRef Kopp S, Carlsson GE et al (1987) Long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis. J Maxillofac Oral Surg 45(11):929–935CrossRef
16.
go back to reference Kopp S, Wenneberg B, Haraldson T, Carlsson GE (1985) The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction. J Oral Maxillofac Surg 43:429–430CrossRefPubMed Kopp S, Wenneberg B, Haraldson T, Carlsson GE (1985) The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction. J Oral Maxillofac Surg 43:429–430CrossRefPubMed
17.
go back to reference Bertolami CN, Gay T et al (1993) Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 51:232–235CrossRefPubMed Bertolami CN, Gay T et al (1993) Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 51:232–235CrossRefPubMed
18.
go back to reference Wenneberg B, Kopp S, Gröndahl HG (1991) Long-term effect of intra-articular injections of a glucocorticosteroid into the temporomandibular joint: a clinical and radiographic 8-year follow-up. J Craniomandib Disord 5:11–18PubMed Wenneberg B, Kopp S, Gröndahl HG (1991) Long-term effect of intra-articular injections of a glucocorticosteroid into the temporomandibular joint: a clinical and radiographic 8-year follow-up. J Craniomandib Disord 5:11–18PubMed
Metadata
Title
Use of Sodium Hyaluronate and Triamcinolone Acetonide Following Arthrocentesis in Treatment of Internal Derangement of Temporomandibular Joint: A Prospective Randomized Comparative Study
Authors
Ravina Dharamsi
Kumar Nilesh
C. D. Mouneshkumar
Pankaj Patil
Publication date
07-10-2022
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery / Issue 1/2024
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-022-01804-4

Other articles of this Issue 1/2024

Journal of Maxillofacial and Oral Surgery 1/2024 Go to the issue