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The next step in the treatment of persistent temporomandibular joint pain following arthrocentesis: A retrospective study of 18 cases |
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| Affiliation: | 1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey;2. Medical Park Private Bahcelievler Hospital, Istanbul, Turkey;3. Department of Public Health, Faculty of Medicine, Istanbul University, Turkey;1. Dental Student, Harvard School of Dental Medicine, Boston, MA;2. Dental Student, Harvard School of Dental Medicine, Boston, MA;3. Orofacial Pain Medicine Consultant, Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan;4. Visiting Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital; Professor of Oral and Maxillofacial Surgery, Harvard School Dental Medicine, Boston, MA;6. Chief, Division of Oral and Maxillofacial Pain; Director, Orofacial Pain Residency Program, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA;1. Associate Professor, Department of Oral and Maxillofacial Surgery, Al-Azhar University, Faculty of Dental Medicine, Cairo, Egypt;2. Lecturer, Department of Oral and Maxillofacial Surgery, Al-Azhar University, Faculty of Dental Medicine, Assuit, Egypt;3. Researcher, Department of Oral and Maxillofacial Surgery, Al-Azhar University, Faculty of Dental Medicine, Cairo, Egypt;4. Assistant Lecturer, Department of Oral and Maxillofacial Surgery, Beni Suef University, Faculty of Dentistry, Cairo, Egypt |
| Abstract: | Temporomandibular joint disorders affect a big portion of the population. There are a variety of treatment methods currently in use. Conservative treatment modalities are followed by more invasive approaches like arthrocentesis or arthroscopy. The aim of the study is to compare the effects of intra-articular tenoxicam injection and arthrocentesis plus viscosupplementation on patients in which a previous arthrocentesis plus viscosupplementation has failed to relieve pain and restore function. The study group consists of 18 TMJs in 16 patients (15 female and 1 male) and the patients were randomly divided into two groups as the arthrocentesis plus viscosupplementation group (n: 8) and tenoxicam injection (n: 10). 20 mg of tenoxicam was injected to the upper compartments of 10 joints without arthrocentesis. The other 8 joints were treated with a second arthrocentesis and sodium hyaluronate injection. VAS scores and maximum mouth opening with and without assistance were recorded in the post operative first week, first month and third month. The results show that there is little benefit in using relatively conservative methods once an arthrocentesis together with viscosupplementation has failed to relieve the patients pain. It is concluded that more invasive procedures should be considered for the patients who do not benefit from arthrocentesis. |
| Keywords: | Temporomandibular joint Intra-articular injection Arthrocentesis Tenoxicam |
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