Efficacy of Arthrocentesis with Injection of Hyaluronic Acid in The Treatment of Internal Derangement of Temporomandibular Joint

This cross-sectional study was designed to find out the effect of arthrocentesis with injection hyaluronic acid in the treatment of internal derangement of temporomandibular joint (TMJ ID) for the restoration of TMJ function. The study included 25 patients, aged 13 to 50 years with symptoms of TMJ pain and clicking during function and limited mouth opening. TMJ ID was assessed with clinical examination and conformed with MRI. Arthrocentesis was done with insertion of two 21gauze needles in the upper joint compartment and joint lavaged with 200 ml of ringer’s lactate solution and at the end 1ml of hyaluronic acid was injected. Intensity of TMJ pain and clicking was assessed using visual analog scale, maximum mouth opening, lateral jaw movement and protrusion were assessed with millimeter scale. All the parameters were measured before the procedure, immediately after the procedure then after 2 weeks, 1 month, 3 months and 6 months procedure. During 6 months follow-up, clinical examination and comparison of the results showed 84% reduction in TMJ pain, 92 % improvement in mouth opening and clicking disappear in 80 % of patients. Key words: TMJ pain, clicking, internal derangement, arthrocentesis and hyaluronic acid