Abstract
Background
Internal derangement of the temporomandibular joint (TMJ) is one of the most common forms of temporomandibular disorders. The minimally invasive treatments such as arthrocentesis as well as arthroscopic lysis and lavage are often used as a first-line surgical treatment or in conjunction with nonsurgical modalities with low morbidity and high efficacy. Sodium hyaluronate (SH) has been proposed as an alternative therapeutic agent with similar therapeutic effects.
Objective
A prospective study was carried out for evaluation of efficacy of TMJ arthrocentesis with and without injection of SH in management of internal derangements.
Material and methods
A total of 30 patients suffering from internal derangement of TMJ were selected for this study. Patients were randomly divided into the following two groups: group 1—arthrocentesis-only group and group 2—arthrocentesis + SH group. Each group constituted 15 patients.
Results
Six-month postoperative mean mouth opening (MMO) increase was 13.61 ± 1.64 and 15.53 ± 3.01 mm in group 1 and group 2, respectively. At 6 months, there was marked improvement in masticatory efficiency with mean increase of 5.07 ± 0.13 in group 1 and 6.40 ± 0.04 in group 2. Mean pain reduction was 5.27 ± 0.67 and 6.48 ± 0.44 in group 1 and group 2, respectively.
Conclusion
Although our series comprised a limited number of cases and a short follow-up period, initial results suggested that arthrocentesis with SH injection seemed to be superior to art.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Nitzan DW, Dolwick MF, Martinez GA (1991) Temporomandibular joint arthrocentesis. A simplified treatment for severe limited mouth opening. J Oral Maxillofac Surg 49:1163–1167
Lee S, Yoon HJ, MRI (2009) Findings of patients with temporomandibular joint internal derangement: before and after performance of arthrocentesis and stabilization splint. J Oral Maxillofac Surg 67:314–317
Vasconcelos BC et al (2006) Temporomandibular joint arthrocententesis: evaluation of results and review of the literature. Rev Bras Otorrinolaringol 72(4):634–638
Alpaslan GH, Alpaslan C (2001) Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements. J Oral Maxillofac Surg 59:613–618
Luca G-N, Marco S, Chiara B, Luigi S, Daniele M (2007) A one-year case series of arthrocentesis with hyaluronic acid injections for temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:e14–e22
Cascone P, Fonzi Dagger L, Aboh (2002) Hyaluronic acid’s biomechanical stabilization functions in the temporomandibular joint. J Craniofac Surg 13:751–754
Tozoglu S, Al-Belasy FA, Dolwick MF (2011) A review of techniques of lysis and lavage of the TMJ. Br J Oral Maxillofac Surg 49:302–309
Shakya P, Rahman QB et al (2010) Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint. BSMMU J 3(1):18–22
Bertolami CN (2001) Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements: discussion. J Oral Maxillofac Surg 59:618–619
Brennan PA, Ilankovan V (2006) Arthrocentesis for temporomandibular joint pain dysfunction syndrome. J Oral Maxillofac Surg 64:949–951
Dimitroulis G, Dolwick MF, Martinez A (February 1995) Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study. Br J Oral Maxillofac Surg 33(1):23–27
Murakami K, Hosaka H (September 1995) Short-term treatment outcome study for the management of temporomandibular joint closed lock: a comparison of arthrocentesis to nonsurgical therapy and arthroscopic lysis and lavage. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 80(3):253–257
Nishimura M, Segami N, Kaneyama K, Suzuki T (2001) Prognostic factors in arthrocentesis of the temporomandibular joint: evaluation of 100 patients with internal derangement. J Oral Maxillofac Surg 59:874–877
Kaneyama K (2004) The ideal lavage volume for removing bradykinin, interleukin-6, and protein from the temporomandibular joint by arthrocentesis. J Oral Maxillofac Surg 62:657–661
Emshoff R (2005) Clinical factors affecting the outcome of arthrocentesis and hydraulic distension of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 100:409–414
Ohnishi M (1990) Arthroscopy and arthroscopic surgery of the temporomandibular joint (TMJ). Rev Stomatol Chir Maxillofac 91:143–150
Alkan A, Bas B (2007) The use of double-needle cannula method for temporomandibular joint arthrocentesis: clinical report. Eur J Dent 1:179–182
Guarda-Nardini L, Manfredini D, Ferronato G (2008) Arthrocentesis of the temporomandibular joint: a proposal for a single-needle technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:483–486
Rehman KU, Hall T (2009 Jul) Single needle arthrocentesis. Br J Oral Maxillofac Surg 47:403–404
Alkan A, Kilic E (2009) A new approach to arthrocentesis of the temporomandibular joint. Int J Oral Maxillofac Surg 38:85–86
Shinjo H, Nakata K, Shino K et al (2002) Effect of irrigation solutions for arthroscopic surgery on intraarticular tissue: comparison in human meniscus-derived primary cell culture between lactate Ringer’s solution and saline solution. J Orthop Res 20:1305–1310
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Source of funding
Not required.
Rights and permissions
About this article
Cite this article
Patel, P., Idrees, F., Newaskar, V. et al. Sodium hyaluronate: an effective adjunct in temporomandibular joint arthrocentesis. Oral Maxillofac Surg 20, 405–410 (2016). https://doi.org/10.1007/s10006-016-0581-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10006-016-0581-2