Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements

Purpose: This study was designed to investigate the efficacy of arthrocente sis with and without injection of sodium hyaluronate (SH) into the upper jo int space in the treatment of temporomandibular joint (TMJ) internal derang ements. Patients and Methods: Forty-one TMJs in 5 males and 26 females aged 14 to 5 3 years comprised the study material. The patients' complaints were limited mouth opening, TMJ pain and tenderness, and joint noises during function. Patients were randomly divided into 2 groups in which only arthrocentesis w as performed in I group and arthrocentesis plus intra-articular injection o f sodium hyaluronate was performed in the other group. Both groups containe d patients with disc displacement with reduction and with closed lock. Clin ical evaluation of the patients was done before the procedure, immediately after the procedure, on postoperative day 1, and at 1, 2, 3, 4, 5, 6, 9, 12 , 18, and 24 months postoperatively. Intensity of TMJ pain, jaw function, a nd clicking sounds in the TMJ were assessed using visual analog scales. Max imal mouth opening and lateral jaw movements also were recorded at each fol low-up visit. Results: Both techniques increased maximal mouth opening, lateral movements , and function, while reducing TMJ pain and noise. Conclusions: Although patients benefitted from both techniques, arthrocente sis with injection of SH seemed to be superior to arthrocentesis alone. (C) 2001 American Association of Oral and Maxillofacial Surgeons.