Evaluation of the effect of intra-articular injection of macrolide antibiotics versus corticosteroids on internal derangement of temporomandibular joint.

Abstract

Temporomandibular disorders (TMD) are conditions clinically characterized by pain and dysfunction in the masticatory muscles, temporomandibular joints (TMJs), and adjacent structures.The goal of treatment for TMDs is elimination or reduction of pain and maintain normal temporomandibular joint function, preventing further joint damage, and reducing disease-related morbidities. Immediate postoperative intra-articular drugs injections are currently being combined with arthrocentesis to treat both pain and the inflammatory disease process and improve outcomes. The aim of this study was to assess the efficacy of intra-articular injection of macrolides versus corticosteroids in improving outcomes after temporomandibular joint (TMJ) arthrocentesis in internal derangement (ID) of the joint due to anteriorly non reducing disc displacement.The study included 24 patients with internal derangement of the temporomandibular joint who did not respond to conservative treatment for 3 months. Patients were randomly divided into 2 equal groups according to the intra-articular drug injected after arthrocentesis. In group I, a corticosteroid is injected and in group II a macrolide with a known anti-inflammatory effect is used. Pain, mouth opening and analysis of Tumor Necrosis Factor-α (TNF-α) concentration were used as indicators of symptoms alleviation and patients improvement.In both groups, the median pain scores and MMO measurements after three months showed statistically significant lower values compared to pre-operative ones. In Conclusion, intra-articular injection of Azithromycin is comparable to corticosteroids injection as an effective method for treatment of the underlying disease process of internal derangement of the TMJ and alleviation of disease associated symptoms, such as pain and limitation of mouth opening. K