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Journal of Maxillofacial and Oral Surgery

, Volume 16, Issue 4, pp 479–484 | Cite as

Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial

  • Harsha Gorrela
  • J Prameela
  • G Srinivas
  • B Vijay Baskar Reddy
  • MVS Sudhir
  • Gururaj Arakeri
Comparative Study

Abstract

Purpose

This study was designed to investigate the efficacy of the temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate (SH) in the treatment of temporomandibular joint disorders.

Patients and Methods

A total of sixty two TMJs in 34 males and 28 females aged 20–65 years comprised the study material. The patients’ complaints were limited mouth opening, TMJ pain, and joint noises during function. Patients were randomly divided into 2 groups in which arthrocentesis plus intra-articular injection of sodium hyaluronate was performed in 1 group and only arthrocentesis was performed in the other group. Both groups contained patients with disc displacement with reduction and without reduction. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, at 1 week and 1, 3 and 6 months postoperatively. Intensity of TMJ pain was assessed using visual analog scales. Maximal mouth opening and lateral jaw movements also were recorded at each follow-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, arthrocentesis with injection of SH seemed to be superior to arthrocentesis alone.

Keywords

TMJ Arthrocentesis Hyaluronate 

Notes

Compliance with Ethical Standards

Conflict of interest

None.

Ethical Committee Approval

Ethical committee approval as obtained by the institutional Ethical Committee MNR Dental College & Hospital, Sangareddy, TELANGANA.

References

  1. 1.
    Kunjur J, Anand R, Brennan PA, Ilankovan V (2003) An audit of 405 temporomandibular joint arthrocentesis with intra-articular morphine infusion. Br J oral Maxillofac Surg 41(1):29–31CrossRefPubMedGoogle Scholar
  2. 2.
    Tan DBP, Krishnaswamy G (2012) A retrospective study of temporomandibular joint internal derangement treated with arthrocentesis and arthroscopy. Proc Singapore Healthc 21(1):73CrossRefGoogle Scholar
  3. 3.
    Guarda-Nardini Luca, Stifano Marco, Brombin Chiara, Salmaso Luigi, Manfredini Daniele (2007) Padova, Italy. A one-year case series of arthrocentesis with hyaluronic acid injections for temporomandibular joint osteoarthritis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:14–22CrossRefGoogle Scholar
  4. 4.
    Yeung Richie Wai Kit, Chow Raymond Lop Keung, Chiu Ken (2006) Short-term therapeutic outcome of intra-articular high molecular weight hyaluronic acid injection for nonreducing disc displacement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102:453–461CrossRefPubMedGoogle Scholar
  5. 5.
    David E, Frost MS, Kendell BD (1999) The use of arthrocentesis for treatment of temporomandibular joint disorders. J Oral Maxillofac Surg 57:583–587CrossRefGoogle Scholar
  6. 6.
    Quinn JH, Bazan NG (1990) Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporo mandibular joints. J Oral Maxillofac Surg 48:968–971CrossRefPubMedGoogle Scholar
  7. 7.
    Radin EL, Paul IL, Swann DA, Shottstaedt ES (1971) Lubrication of synovial membrane. Ann Rheum Dis 30:322–325CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Gotoh S, Miyazaki K, Onaya J, Sakamoto T, Tokuyasu K, Namiki O (1988) Experimental knee pain model in rats and analgesic effect of sodium hyaluronate (SPH). Folia Pharmacol Japon 92:17–27CrossRefGoogle Scholar
  9. 9.
    Gotoh S, Onaya J, Sakamoto T, Tokuyasu K (1988) Protective effect of sodium hyaluronate (SPH) against adhesion formation in flexor tendon of rats. Pharmacometrics 35:359–364Google Scholar
  10. 10.
    Hishashi N, Ishimaru JI, Kurita K et al (1997) The effect of hyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep. J Oral Maxillofac Surg 55:1114CrossRefGoogle Scholar
  11. 11.
    Kopp S, Carlsson GE, Haraldson T et al (1987) The long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis. J Oral Maxillofac Surg 45:929CrossRefPubMedGoogle Scholar
  12. 12.
    Bertolami CN, Gay T, Clark GT et al (1993) Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo-controlled clinical trial. J Oral Maxillofac Surg 51:232CrossRefPubMedGoogle Scholar
  13. 13.
    Nitzan DW, Samson B, Better H (1997) Long-term outcome of arthrocentesis for sudden-onset, persistent, severe closed lock of the temporomandibular joint. J Oral Maxillofac Surg 55:151CrossRefPubMedGoogle Scholar

Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2016

Authors and Affiliations

  • Harsha Gorrela
    • 1
  • J Prameela
    • 1
  • G Srinivas
    • 1
  • B Vijay Baskar Reddy
    • 1
  • MVS Sudhir
    • 1
  • Gururaj Arakeri
    • 2
  1. 1.MNR Dental College and HospitalSangareddyIndia
  2. 2.Navodaya Dental College and HospitalRaichurIndia

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