P-41648991-93 - Arthocentesis and adjuvant intraarticular steriod in the management of internal derangement of temporomandibular joint

Abstract

<h3>Objectives</h3> A study was designed to compare the efficacy of arthrocentesis alone and with intraarticular steroid in treatment of TMJ internal derangements. <h3>Methods</h3> 36 patients diagnosed cases of internal derangement, aged between 17-45 years. Wilkie's second and third stage were enrolled in the study, complaining of limited mouth opening and TMJ pain. All patients were clinically evaluated before the arthocentesis, and at 1 week and 3 months after the arthocentesis after randomly distributed into two groups by lottery method. In the experimental group arthocentesisis was combined with single dose of triamecelone actonide 40mg injection into joint space. Postoperative changes were compared with the preoperative values using the Mann-Whitney U-test. <h3>Results</h3> The pre-operative mouth opening ranged from 18 to 27mm with a mean of 23.7mm with VAS pain score from 4 to 8 in control group. The post-operative MMO incresed to mean of 33.475mm and increased to a mean of 41.05mm at 3 month follow-up with decrease in pain score to a mean of 2.45 at 1 week then to a mean of 1.225 at 3 month follow-up in the control group. In the experimental group the mean MMO after steroid injection increased from 23.9 to 42.2mm, the mean pain score decreased from 6.7 to 1.11. The difference between the groups was not significant with p value of 1. <h3>Conclusion</h3> TMJ arthrocentesis is a simple, less invasive and less expensive technique with low morbidity, but addition of steroid doesn't improve the results.