Comparativestudy Between Tramadol Hydrochloride and Sodium Hyaloronatefor Management of Tempromandibular Joint Internal Derangement

Abstract

Purpose. This study was conducted to evaluate the efficacy and safety of arthrocentesis with injection of tramadol hydrochloridefor management of tempromandibular joint with internal derangement compared with traditional method with sodium hyaloronate injection.Patient&methods.The study was conducted on forty patients classified as class ASA type I with chief complain of limited mouth opening, TMJ pain, and clicking sounds in the TMJ was included in this study. All patients included in the study was selected from the outpatient clinic oforal and maxillofacial department, faculty of dentistry, Suez canal university.The selected patients were divided randomly into two equal groups,group I:consists of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, commercially available tramadolhydrochloride.GroupII: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. commercially available sodium hyaloronate.Evaluation of the patients was done preoperatively, after1,3,6 months postoperativelywhich includedmaximal mouth opening, pain&clicking sound presence in TMJ.Results.patients with either disc displacement with reduction or without reductionwere benefited from the arthrocentesis procedure with injection of Sodium Hyaluronate and also with tramadol hydrochloride.Both treatments were able to reduce pain levels, increase maximal mouth opening and reduce clicking withstatistically significant difference. However, arthrocentesis with injection of tramadol hydrochloride was superiorto arthrocentesiswithinjection of sodium hyaluronate in terms oftreatment of internal derangements of the temporomandibular joint.Conclusion. It has been concluded arthrocentesis is an effective conservative procedure in treatment of temporomandibular joint internal derangement,clinical efficacy of arthrocentesis with tramadolhydrochloride in the temporomandibular joint internal derangements&safty of tramadolintraarticular injection in the temporomandibular joint.